Approach
Mary Washington discovered that ESI (emergency severity index) level three patients were driving up the overall fast-track length of stay, which prompted them to radically refine fast track patient eligibility. Using results from data analysis, administrators restructured the fast-track to include only ESI level four and five patients and renamed the area the “Super Track.”
In addition to refining the inclusion criteria, Mary Washington administrators tracked the arrivals of low-acuity patients to the emergency department by time of day to determine peak demand. Then, they used that information to staff the Super Track with two physician assistant-nurse teams, each of which has the ability to handle at least two patients per hour. With lower-acuity cases to treat, the staff is able to cycle through one to two more patients per hour than the previous fast-track area.