Northwestern Medicine’s clinical operations team focuses on enhancing the care delivery model in the face of ever-present Emergency Department challenges, particularly with Emergency Department crowding and the care of vulnerable patient populations. Through redesigned patient flow, innovative programs and improved care coordination and community relationships, the operations team strives to advance the care for patients in the Chicagoland area.
In 2019, Northwestern Memorial Hospital was accredited as a Level 1 Geriatric Emergency Department, the highest tier of GED accredited by the American College of Emergency Physicians.
The accreditation is a testament to the work of the Geriatric Emergency Department Innovations (GEDI) program which began in 2012 with support from the Davee Foundation and a Centers for Medicare and Medicaid Services Health Care Innovations Award. The GEDI program consists of a multi-disciplinary team spearheaded by transitional care nurses, which includes social workers, pharmacists, physical therapists, and occupational therapists who work as a team to improve the care of older adults in the Emergency Department (ED). The GEDI team works to identify geriatric syndromes and risks and work to returning older adults home safely following care in the Emergency Department. Importantly, the GEDI team communicates with outpatient clinicians and performs follow up phone calls with patients to ensure that they are receiving the proper care when they are discharged.
The GEDI program has seen a sharp reduction in hospitalizations among older adults. In a study published in 2018, patients who had care coordinated by a TCN were admitted 36% of the time, compared to 53% of matched comparison patients who did participate in the GEDI program.
With the success of the GEDI program, Dr. Dresden was awarded an R01 in 2019 from the Agency for Healthcare Research and Quality to further study the benefits of the GEDI program for patients, including measuring the impact of GEDI on patients Health Related Quality of Life.
Emergency Department Projects
The spirit of interdisciplinary collaboration that pervades Northwestern creates a dynamic and ideal environment to conduct administrative and operational research. Current projects include:
NeuroSpell Pathway - Clinical Pathway designed to expedite outpatient MRIs and neurology follow up for patients seen in the Emergency Department with neurological complaints, who previously would have had to be admitted for the same care plan. Led by and presented by Kumar Gandhi, PGY4 at The Emergency Department Operations Study Group 2018 Conference
Low-Risk Chest Pain Pathway - Clinical Pathway designed to expedite outpatient stress testing and cardiology follow up for patients seen in the Emergency Department with low risk chest pain, who previously would have had to be admitted for the same diagnostic work up. Led by Julian Richardson, PGY3
Code Neutropenic Fever - Design and implementation of a clinical protocol to increase identification of neutropenic fever patients early in their course and initiate key diagnostic procedures and therapies including blood cultures and antibiotic therapy within an hour. Led by Justin Seltzer, PGY3
Telemetry Optimization - Educational intervention with visual aid in the Emergency Department to help hone the use of telemetry orders upon admission to those patients who need them in order to preserve resources and expedite care. Led by Logan Wedel, PGY2
Academy for Quality and Safety Improvement (AQSI) Projects
Team "All is Well's" - Led by PGY2 Em Wessling, the team also includes residents: Peter Serina, Vytas Karalius, Niki Patel, and Alex Ireland with faculty support by Tim Loftus. This team's work focuses on CTPE utilization in the ED with an EHR-based clinical decision support tool.
PE Team - Led by PGY3 resident, Amanda Randolph.
2018-2019 AQSI Team
Led by PGY4 Dana Loke, the team also includes residents: Laurie Aluce, Andra Farcas, and Justine Ko with faculty support from Abra Fant and Nahzinine Shakeri. This AQSI team focused on gender disparities in ED radiology turn-around-time in the ED. Their work was presented at the 2019 Society of Academic Emergency Medicine Annual Meeting as well as the Inaugural Women in Medicine Summit 2019.
2017-2018 AQSI Team
Led by former residents Jonathan Andereck and Quentin Reuter, this team also includes former resident Aaron Quarles, ED pharmacist Katie Allena and faculty support by Howard Kim. The team's quality improvement initiative focused on peer-comparison prescribing feedback for ED opioid prescriptions. Their findings were published in The Joint Commission Journal on Quality and Patient Safety, 2019.