SPH AMBULANCE VISITS by CTAS

0

1000

2000

3000

4000

5000

6000

7000

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHERS

2002

2003

2004-5 Total Volume

2002 11894

2003 12788

2004-5 14749

SPH INPATIENT ADMITS BY CTAS

0

500

1000

1500

2000

2500

3000

3500

4000

4500

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHER

2002

2003

2004-5 Total Volume

2002 6794

2003 7414

2004-5 8292

SPH TOTAL VOLUME BY CTAS

0

5000

10000

15000

20000

25000

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHER

2002

2003

2004-5 Total Volume

2002 46505

2003 49632

2004-5 57010

SPH LWBS by CTAS Level

0

100

200

300

400

500

600

700

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHER

2002

2003

2004-5 Total LWBS Percent

2002 1023 2.2%

2003 1327 2.7%

2004-5 1430 2.5%

SPH Percent Volume Change Corporate Year over Year

4412147714

50672

57010

61997

8.1%

5.8%

12.5%

8.7%

0

10000

20000

30000

40000

50000

60000

70000

2001-02 2002-03 2003-04 2004-05 2005-06(projected)

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%Total Volume

% Change

SPH Admission Rates by CTAS Level (admits/total per category)

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5

2002

2003

2004-5

% patients never getting to an acute side bed during ED care SPH

0%

5%

10%

15%

20%

25%

30%

35%

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5

2002

2003

2004-5

Total Volumes with only Waiting

Room care

2002 2401

2003 3104

2004-5 4990

% patients with immediate acute bed

placement on ED Arrival SPH

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5

2002

2003

2004-5Total Volumes to

Acute Area

2002 17154

2003 18595

2004-5 22113

MSJ Volumes by CTAS

0

1000

2000

3000

4000

5000

6000

7000

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHER

2003-4

2004-5

Total Volume

2003-4 13969

2004-5 15598

2005-6

(projected)

17148

MSJ Admission by CTAS

0

200

400

600

800

1000

1200

1400

1600

1800

2000

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHER

2003-4

2004-5

Total Volume

2003-4 2374

2004-5 2613

MSJ LWBS by CTAS

0

10

20

30

40

50

60

70

80

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 OTHER

2003-4

2004-5

Total Volumes

2003-4 177

2004-5 120

MSJ 2004-05 Initial Bed Placement

20

69

9

41

36

42

61

14

08

8

24

3

21

16

20

19

66

60 1000 2000 3000 4000 5000 6000 7000

CTAS 1

CTAS 2

CTAS 3

CTAS 4

CTAS 5

BED AVAILABLE TO WAITING ROOM

MSJ Annualized Volumes Calendar 2004-2005

MSJ ANNUALIZED PATIENT VOLUME-BY MONTH

1000

1100

1200

1300

1400

1500

1600

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2004

2005

2004-5 Volumes by Day of Week

14.0% 13.9% 14.3% 14.1% 14.2% 14.4%

14.2%13.8%14.5%14.0%14.2%14.0%14.9%

15.0%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY

MSJ

SPH

Total Volumes

MSJ 15598

SPH 57010

2004-5 Volumes by Hour of the Day

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

0:00

2:00

4:00

6:00

8:00

10:0

0

12:0

0

14:0

0

16:0

0

18:0

0

20:0

0

22:0

0

MSJ

SPHTotal Volumes

MSJ SPH

HOUR

8 – 15

(N)

9829

HOUR

8 – 16

(N)

23798

15 - 21 5764 16 - 24 21948

OTHER 3 24 -8 11264

TOTAL 15596 TOTAL 57010

SPH Monthly Volumes

SPH ANNUALIZED PATIENT VOLUME-BY MONTH

3,000

3,500

4,000

4,500

5,000

5,500

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2000

2001

2002

2003

2004

2005

NOTES:1 Event not captured in information systems

2 Transfer to Acute (TAC) is the time that admitted doc decided that the patient should be admitted. It is also the O/ER discharge time for admittedpatients. TAC is the admission time recorded in Health Records for the inpatient stay.

3 Triage time is captured on the chart and used as O/ER admission time. ER admission time is the ADT admission time for Inpatients who are transferred from ER.

4 ED LOS is the time from triage to ED discharge.

Time to MD based on CTAS level

Outpatients are discharged home or leave AMA anytime

Arrival 1

EMERGENCY ROOM EFFICIENCIES HOSPITAL/PROGRAM EFFICIENCIES

Seen ByMD Time

Initial ER ConsultOrder Time

CONSULTING SERVICES EFFICIENCIES

Transfer to Acute(TAC) Time 2

Consults Occur 1

Transfer Wait

TriageTime 3

ED LOS 4

Transfer toUnit Time

Percent Admitted from ER to Unit within 10 hours

Average Consult to TAC by Program

Avg Consult to TAC by Program

3.9

5.3

4.8

0

1

2

3

4

5

6

HCP MED MHP

Program

Ad

mit

to

TA

C (

Hrs

)

HCP MED MHP

Average TAC to Transfer by ProgramAvg TAC to Transfer by Program

5.911.1

76.8

0

10

20

30

40

50

60

70

80

90

HCP MED MHP

Program

TA

C t

o T

ran

sfer

(H

rs)

HCP MED MHP

Percent of ER Total Time by Key Time Points

15.6%

26.6%

57.9%

0%

10%

20%

30%

40%

50%

60%

70%

Triage to Consult Consult to TAC Time TAC to Transfer

Time Points

Pe

rce

nt

of

ER

To

tal T

ime

SPH 2004-5 Housestaff Volumes*

0

5000

10000

15000

20000

25000

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5

RESIDENT

STUDENT/IMG

TOTAL

•Only those patients who have a resident/student sign up in SCM included. R3s not separated out.

% OF TOTAL

CTAS 1 14.5%

CTAS 2 15.2%

CTAS 3 18.4%

CTAS 4 14.8%

CTAS 5 14.3%

Time to Physician SPH 2004-5

CTAS PATIENTS* (N)

MEDIAN (MIN)

90%ILE (MIN)

1 271 8 38.5

2 5755 22 62

3 17143 29 74

4 21172 40 88

5 8810 41 90UNKNOWN 214 28 74.5

TOTAL 53365 34 82

*time seen completed

MEDIAN TIME TO MD 2004-5

19

25

36 37 36

22

29

40

8

41

0

5

10

15

20

25

30

35

40

45

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5

TIM

E T

O M

D (

MIN

)

MSJ

SPH Total Median Time

MSJ* 36 min

SPH 34 min

*MSJ data from Oct 18/2004 onwards

90%ile TIME TO MD 2004-5

37

63

83 8285

62

74

88 90

38.5

0

10

20

30

40

50

60

70

80

90

100

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5

TIM

E T

O M

D (

MIN

)

MSJ

SPH

Total 90%ile Time (Min)

MSJ* 82 min

SPH 82 min

*MSJ data from Oct 18/2004 onwards

SPH Visit Reason* 2004-5

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

01 02 03 04 05 06 07 10 U/K

SPH

MSJ

*See following figure for explanation of code. Codes are CEDIS based.

SPH 2004-5: Total Volume by MD*

2467

630

1996

1320

1934

2436

1096

3006

1835

2585

14191554

808

2675

1227

532

2426

1505

1765

2702

804649

2270

2052

1802

514

1879

222

890

0

500

1000

1500

2000

2500

3000

3500

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

*LWBS not included

SPH 2004-5: Volumes by MD CTAS 4 – 5*

1301

314

1098

662

1159

1415

776

1726

1121

1609

778802

486

1429

604

217

1350

798

982

1458

429

302

12581177

1011

250

1133

103

364

0

200

400

600

800

1000

1200

1400

1600

1800

2000

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

*LWBS not included

Unadjusted Patients/Shift by MD SPH 2004-5

17.518.3

20.5

17.717 17

17.718.3

17.1

20.8

19 19.3

16.6

19

16.115.4

18.717.7

15.715.5

19

16.1

19.2

17.116.2

15.1 15

19.418.7

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

X = 17.6, SD = 1.6

Percentage Fast Track by MD SPH 2004-5

33%32%35%

26%

42%38%

70%

39%

52%54%

35%

29%

44%

35%

29%

21%

38%34%

32%33%37%

29%

36%39%

35%33%

43%39%

17%

0%

10%

20%

30%

40%

50%

60%

70%

80%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

Adjusted Patients/Shift Score by MD SPH 2004-5

0

5

10

15

20

25

30

35

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

X = 26.1, SD = 2.6