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Practice Reduces Door-to-Provider Time

Case Study

The Challenge

A suburban community hospital wanted to decrease its Left Without Being Seen (LWBS) rates by providing patients with a face-to-face evaluation with the provider within 30 minutes of arrival.

They had determined that door-to-provider time was the number one patient satisfaction driver, with the “Excellent” threshold at less than 30 minutes and the best ED practice nationally at 15 minutes.

The Solution

First, the practice implemented a 12-hour advanced practice provider (APP) shift in triage from 10 a.m. to 10 p.m. to do rapid medical evaluations during their busiest time. Then, the department worked to shift from reactive to proactive problem solving in all its patient interactions.

Leadership also reviewed the process flow chart and adjusted it to expedite the patient to physician encounter while decreasing waits and delays. Any impediments to this encounter were immediately reduced or eliminated.

The team agreed that process improvement relied on working together at all levels and keeping the same goal in mind was key to success. For any team members who needed it, in-service training was provided so that everyone could continue to move forward together.

The Results


The department was happy to see that they successfully achieved their goal of seeing patients in less than 30 minutes of arrival. They also reduced throughputs and LWBS rates, which resulted in better overall care and investment in each individual who entered the practice.

Continuous Improvement requires a team approach which is only possible in an environment that values physician ownership, innovation and creative problem solving. This practice worked together at every level to improve the overall quality of the patient experience in their department.


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