The 2009 numbers are in, and they are impressive. Since taking over management of the Alvarado Hospital emergency department in April 2008, Medical Director Kevin Kelly, MD, and his team have implemented strategies that have reduced length of stay and boosted volume.
“The typical time to see a doctor in our ER is under 30 minutes,” said Dr. Kelly. “Our LOS goals are three hours for admission and two hours for discharge, respectively, and we are getting close.”
In comparison, county data reported by participating San Diego hospitals from June 2008 through July 2009 averaged 5.9 hours for admission and 3.4 hours for discharge, respectively. Another dramatic improvement has been the 86% reduction in ER diversion. During 2007, the Alvarado ER was closed for 350 hours. Last year, the ER closed for a total of 47.8 hours. During 2009, there were months with zero diversionary hours. At the same time, ambulance visits to Alvarado have increased by 16%, and total ER volume has increased by 12.7%. Overall, the hospital has seen a 6.7% increase in ER admissions.
To accomplish a reduced LOS and diversion, the physicians have implemented several important changes, including expanded physician coverage. The ER now has 36 hours of physician coverage per day, with double coverage during the busiest times.
“For us to succeed, the hospital has to succeed,” Dr. Kelly said. “The expectation of the community is that there will be an emergency bed when they need it at Alvarado. Our mission is to remain open and available at all times, and to provide the highest quality, most efficient emergency medicine possible.”