Overlook Medical Center Emergency Services, Summit Campus

Summit, New Jersey

Patients leaving the emergency department without a medical screening exam pose a safety concern which can lead to adverse events due to lack of treatment. Overlook Medical Center Emergency Services, Summit Campus is committed to fostering a culture of urgency to prevent patients leaving the ED prematurely and reduce this metric to less than 2 percent. Senior leadership, medical providers, the ED clinical nursing team and ancillary departments are held accountable when metrics are negatively impacted. The daily and monthly dashboards provide an at-a-glance visibility into past and current data to help guide performance improvement initiatives.

In 2022 the annual percentage of left without being seen was 2.4 percent. Utilizing lean methodology, stakeholders explored contributing factors to the rise in LWBS. Three leading factors identified were: lack of nurse-driven triage protocols; lack of a medical provider in triage; and delays in phlebotomy. As a result, nurse drive protocols were revised, and additional ones were created. A medical provider was designated to the triage area and additional ED positions were created for phlebotomists. These changes have resulted in a decrease in the 2023 annual LWBS to 1.2 percent.