Risk Issues & Cost/Value Analysis
The Assumption of Risk
The assumption of risk in a hospital begins when a person presents for treatment and up to 50% of all hospital admissions begin in the emergency department. While risk varies as patient treatment progresses from department to department, it is safe to conclude that the one department which preempts all others in terms of percentages of significant risk is the emergency department. Focusing on addressing risk issues at that point of entry will significantly reduce overall risks hospital-wide. This is why partnering with Triage First for finding solutions on risk reduction for your emergency department will lead to overall risk reduction for your hospital.
Why We Are Different and Effective in Reducing Risk
Our formula is simple. We (1) consult, (2) educate, (3) implement, and (4) provide a web-based portal through which to manage tasks, teams, and timelines. As a function of the Triage First ED Evaluation, we review approximately 50 areas of concern in the emergency department, each of which is associated with some level of risk. Following our presentation of the ED Evaluation's findings, we will generally recommend that all ED staff be educated regarding the needed changes so that everyone is on the same page. Following the education of the staff, we begin our implementation phase, using senior consultant assignments, Virtual Implementation Services (VIS), and the online ED CQI portal.
As one example of minimizing risk, Triage First consulted, educated, and implemented at “XYZ Hospital.” This facility had a four-tier triage system to expedite disposition from triage. Our consultants retrieved 181 ED charts at random, spanning a period of 6 months. Of the charts assigning acuities, the consultants made this exhibit of their findings:
The annual census at XYZ Hospital was 20,000 at the time of the consult. According to the documented acuity assignments, not a single patient presented as "Emergent" during the 6-month period. Clearly, something was wrong with the acuity assignments at this hospital. You can easily sense the high level of risk there—just in this one area alone.
A very careful review was conducted of the presenting symptoms and nursing assessments from all 181 charts and the findings documented. Our consultants, using XYZ emergency department's own written criteria for appropriate assignments, amended all charts and made this exhibit of their findings:
Twenty-eight patients presented to XYZ emergency room with symptoms that met their established criteria for Emergent, but were assessed and assigned Urgent or Semi Urgent at the time. These assignments consequently resulted in increasing patient wait times, delayed or missed reassessments, and increased patient dissatisfaction. Therefore, risk was highly elevated for this population in particular, but also carried over into other areas of process and care.
Examining other risk issues (Against Medical Advice, Left Prior to Medical Screening Exam, Elopement, Patient Complaints, Patient Education, Transfers, Diversions, Delays in Treatment, Security and Patient Safety, and Patient Satisfaction), XYZ Hospital's emergency department was found to be in a category of extreme high risk – the very reason XYZ Hospital requested Triage First's consultation.
XYZ's emergency department administration team worked with Triage First until all of their issues (Triage First's findings) were addressed, their staff was educated, and the goals for this department were reached. The ROI for partnering with Triage First was realized within months of the implementation phase start-up. Today, XYZ's emergency department enjoys a new ED culture which is safer and more efficient, with an increase in patient satisfaction and a very significant reduction in risk.
Call today and arrange to speak with one of our consultants: 828 628 8029 
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