Innovative Emergency Care
Emergency Department Operations
| Leadership teams from around the world have visited the University of Colorado Hospital ED to learn first-hand about our innovative approach to ED operations and flow. |
| We have completely eliminated triage. Triage is designed to identify who can wait, and if patients don’t need to wait, triage does not add value. Upon arrival to the main ED entrance during peak times, patients are immediately greeted and placed into one of four intake rooms where they are seen and evaluated by an attending physician, with a median door-to-provider time less than 7 minutes. |
| Care is initiated immediately, and patients may be quickly moved to SuperTrack or the Main ED, depending on their needs. Patients who do not require additional testing may have their entire care concluded by the intake physician, resulting in a short overall length of stay, typically less than 30 minutes. |
| SuperTrack is a blend of fast-track care (patients with minor illness or injury such as lacerations or fractures) and vertical mid-track care (patients with limited comorbidities with moderate-complexity emergency conditions, such as abdominal pain, headache, vomiting, kidney stones, or low-risk chest pain). A highly-skilled team of ED nurses, technicians, and advanced practice providers (physician assistants or nurse practitioners) are dedicated to SuperTrack during peak times. |
| Patients who require more complex testing and evaluation are transported to the Main ED after their evaluation by the intake physician. Patients arriving via ambulance and those arriving during off-peak hours have a Main ED bed assigned upon arrival. The entire team uses a “swarm” approach to evaluate the patient together and initiate their care immediately upon arrival. |
| Each Main ED room is an identical private room with ample room for visitors, a privacy curtain and glass door, a television, and a telephone. There are no routine hallway beds in our ED. |
| The ED also has four resuscitation rooms that allow us to bring a large team to the bedside of our most critically ill and injured patients. We utilize these rooms to care for patients with cardiac arrest, stroke, and significant trauma. |
| The ED has dedicated suites for state-of-the-art imaging, including a next-generation CT Scanner, high-fidelity ultrasound equipment, and digital x-ray imaging. |
| An adjoining 24 observation beds in our ED Clinical Decision Units (CDUs) are staffed by dedicated teams of ED staff and providers, including 9 beds designed specifically for the comfort and safety of our behavioral health patients. |
| Our Patient Navigators are available to provide referrals to primary and specialty care and address social determinants to health. |
| ED-dedicated social work, care management, behavioral health, and physical therapy teams ensure that patients’ care is well-coordinated and streamlined, whether the next step is post-acute care, rehabilitation, skilled nursing, behavioral health placement, home healthcare, or other disposition. |
| Tightly-integrated information systems and an advanced electronic health record empower staff to keep clinical and operational information at their fingertips, including interactive care pathways, screening algorithms for high-risk conditions, digital communication with consultants and admitting teams, flow and patient movement tracking and signalling, and advanced data analytics. |
Quality and Safety
Our Mission
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| Our Quality/Case Review process examines >2,000 cases annually using a "just culture" framework and has been emulated by numerous departments and facilities as a best-in-class system. |
| Multiple UCH ED quality and throughput metrics are among the top in the nation. We have been recognized for top-decile performance in Vizient and for ED flow metrics (such as length of stay and door-to-provider time) that are among the fastest of any academic ED in the United States. |
| The Emergency Medicine Pathways program decreases practice variability and improves patient health outcomes by working with numerous stakeholders and specialties to create over 120 clinical care pathways. These are based on the best medical evidence and are integrated in the electronic health record for single-click activation and order entry. |
| The Fellowship in Administration, Quality and Operations is a partnership with the Business School at the University of Colorado Denver designed to prepare future leaders by developing expertise in quality management, process improvement, human resource management, financial management, information technology, program development, observation medicine, ED operations, and overall leadership. |