CitationThis initiative required all facilitiesʼ EDs to achieve door to doctor time <30 minutes, ancillary turnaround time (TAT) <60 minutes, total length of stay (LOS) <150 minutes, left without being seen (LWBS) <1%, and Emergency Department Patient Experience of Care (ED-PEC) Top Box >70%. AHMC utilized prospective improvement process tools such as LEAN, monthly site visits, best practice and quality meetings, and social media reviews. AHMC implemented an internal centralized online data collection tool through all facilities and AHMC corporate with the ability to track Centers for Medicare and Medicaid Services (CMS) mandated metrics.Results: By the end of FY 2016, AHMC hospitals reduced their LOS from over 200 minutes to 180 minutes, LWBS rates decreased from 3-5% to less than 1%, door to doctor times decreased to an average of 31 minutes, and EDPEC satisfaction scores increased from 44% to 50%. Conclusion: AHMC's EDsʼ significant improvement demonstrated the strong potential of replicating their efforts on improving patient experience and quality measures to other departments and community hospitals.

The Affordable Care Act (ACA) has significantly altered the American healthcare system. Through the establishment of the ACA, Centers for Medicare and Medicaid Services (CMS) introduced Value-Based Purchasing (VBP), a pay-for-performance program, to the hospital payment system. From a community hospital's standpoint, a multifaceted approach to quality and patient satisfaction on better managing the health of the community was recognized: what begins in the community ends in the hospital as a valuable indicator for each individual's well-being. This article depicts the process of utilizing a six-dimensional approach on engaging stakeholders to improve quality of care and patient satisfaction: (1) inpatient, (2) emergency department, (3) employee, (4) physician relationships, (5) outpatient, and (6) community. As the effect of the ACA becomes more prominent, hospitals should maintain their organizational flow and care coordination through the six-dimensional approach to bring patients and their families back to the center of their care.

Background The Emergency Department (ED) is an integral component of community hospitals and provides imperative health care services to the community. However, ED crowding has become a major public health issue that hinders the community from receiving quality emergency care. Objectives The purpose of this study is to evaluate the impact of a LEAN-based intervention on ED performance and patient experience. Methods The study utilized a six month pre-and post-study design to evaluate the changes in ED throughput measures. Metrics used to measure impact of the study were door to doctor time, Length of Stay (LOS), and percent of patients who left without being seen (% Left Without Being Seen, LWBS). Moreover, the study assessed changes in patient experience using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to capture the large number of patients who were admitted as well as Yelp star rating and comments. Results The hospital observed significant reductions in median LOS from 106-to 77-minutes, door to doctor time from 15-to 10-minutes, and % LWBS rates from 2.78% to 0.10%. Gradual increase was observed in both HCAHPS top box scores and Yelp star ratings. Conclusion LEAN thinking facilitates the staff to tailor the interventions to patients' needs. As healthcare moves into a patient-centered care era, social media and patient satisfaction surveys serve as invaluable platforms to engage patients with the intent of improving ED care.

Background:The inspiration for the VSC system came from clinical and personal insights over the past 20-30 years. The VSC system was created for patients who experience discomfort and increased fall risk related to their inability to complete simple tasks. Initial Assessment:The objective pilot study is to provide sufficient evidence that the Voice Smart Care (VSC) System could improve quality of care, patient safety, and patient satisfaction.Choice of solution: Two [Institution 1] hospitals located in Southern California have piloted the VSC system in their inpatient smart rooms. The VSC study was a randomized design in order to investigate the efficiency and satisfaction of VSC system which uses both voice and touch controls versus the current standard of care provided by nurses.Implementation: With a simple QR code scan on a smart phone or tablet, the VSC system is activated. The system demonstrates a high level of potential value to the healthcare industry. Patients, families, friends, and nurses can easily control functions from the nursing station and room.Evaluation: The VSC system utilizes existing hospital technologies and is activated with a simple QR code scan from a smart device. Patients can easily control their environment with verbal or touch commands. [Institution 1] conducted a total of 90 case studies, comprising of 75% nurse, 20% patient's family members, and 5% administrative team. Interventions:The VSC system assists with questions and requests such as "turn off the light," "adjust the bed," "call nurse," and "turn on the Television". The questionnaire follows Technology Acceptance Model and consists of two different aspects: a 5-star rating and patient comments. Questionnaire results were further analyzed to categorize Star rating 4 and 5 into "AGREE" and star rating 1 and 2 into "DISAGREE".Lessons learned: In the first question, "I am satisfied with the system and would recommend use it in future," 97.7% of respondents reported they are satisfied with the system and would recommend its use in the future.

Greater El Monte Community Hospital (GEMCH), the Los Angeles Department of Public Health, and the Centers for Medicare and Medicaid Services assisted in the first documented case of Ebola survivor delivery in the United States. A descriptive qualitative review of GEMCH's events and the limited documented cases of outcomes of baby deliveries among EVD survivors is discussed. Limited resources and capacity in many developing countries impact adversely on the outcomes of the EVD survivors and their neonates. Three lessons for public health workers emerge: (1) the need for the United States to strengthen their capability to manage EVD cases and other highly contagious and severe infectious diseases; (2) the revealing that EVD survivors can deliver normal, EVD free babies when using the recommended guidelines; (3) The need for health care workers to adopt and share the practical procedures in the Recommended Guidelines by the CDC and LADPH from this event are useful and can be shared with the medical fraternity. This case illustrates that EVD survivors can be equally accepted and treated with success at designated health facilities. Demystifying Ebola and eliminating social stigma surrounding the disease is crucial in this undertaking.