MetroHealth Medical Center Parma Emergency Department

Parma, Ohio

At the MetroHealth Medical Center Parma Emergency Department, a safety net hospital that sees more than 31,000 patient visits annually, leadership responded to increasing left without being seen rates through a data-driven workforce initiative. Using patient volume, acuity, boarding and staffing data, leaders developed a split-flow model to address throughput. Additional staffing positions dedicated to split-flow were secured despite organizational hiring challenges. The effort led to a decrease in LWBS rates by 44 percent. By addressing throughput, leadership improved patient satisfaction, strengthened workforce stability, reduced LWBS rates, and reinforced the department’s commitment to providing safe, high-quality emergency care.

To enhance medication safety, the ED launched a nursing-led initiative to improve barcode medication administration compliance through workflow optimization and technology innovation. After identifying limited access to reliable bedside scanning as a barrier, the department implemented iPhone-based Rover devices for every emergency nurse, enabling consistent point-of-care medication verification. Supported by staff education, real-time coaching and leadership engagement, the initiative improved workflow efficiency and reduced barriers in a high-acuity environment. BCMA compliance rapidly increased to 99 percent and was sustained above the 95 percent target, demonstrating the impact of nursing-driven innovation on patient safety, reliability and quality care.