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Northwestern University Feinberg School of Medicine
Department of Emergency Medicine

Current Initiatives

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.

 

We're proud to be among the first Geriatric Emergency Department's in Illinois, an achievement that reflects Northwestern's commitment to providing older patients with comprehensive, high-quality care required to meet their unique healthcare needs.”

Scott Dresden, MD, MS
Associate Professor
Director of Geriatric Emergency Department Innovations (GEDI)
Northwestern Memorial Hospital

GEDI Program

The GEDI program has seen a sharp reduction in hospitalizations among older adults. In a 2018 study, patients with care coordinated by a TCN were admitted 36% of the time compared to 53% of matched comparison patients participating in the GEDI program. 

With the GEDI program success, Dr. Dresden was awarded an R01 in 2019 from the Agency for Healthcare Research and Quality to further study the GEDI program benefits 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:

Super Track

An evolution of the emergency department split-flow model that enables rapid treatment of patients with low-complexity conditions in virtual space, reducing waiting room crowding and improving discharge length of stay, time waiting for provider and lowering walk-out rates.

Radiology Turnaround Time Reduction

Implementation of a queuing process modeled after outpatient clinic imaging within the emergency department, involving space designation and addition of assistant technologists to reduce imaging acquisition times for patients needing X-Rays. Pilot results have shown an improvement of 15 minutes avg. for imaging start times.
Physical queueing processes are also being evaluated to increase secondary CT scanner utilization, in addition to assessing development of an AI-enabled tool to assist with CT study prioritization.

Boarder Care Teams

Implemented an innovative 24/7 care team for boarding patients, operationalizing a 15 bed boarder care unit staffed by physicians and advanced practice providers cross-trained in internal and emergency medicine, complete with hospital medicine nurses.

The boarder care team has resulted in hospitalized patients starting inpatient care 1.8 hours sooner on average, contributing to an additional 8 daily admissions from the ED. Collaboration with psychiatry partners is in progress to open an additional 3 beds for care of psychiatric observation patients. 

Alternative Care Pathways

A comprehensive workstream targeted at reducing inpatient hospitalizations and expediting safe, effective, and patient-centered care in the ambulatory setting. Existing alternative care pathways that have led to on reductions in admissions include:
  • Low & Intermediate Risk Chest Pain pathways
  • Neuro Spell pathway for patients with symptoms of TIA
  • Low Risk Pulmonary Embolism pathway
  • Atrial Fibrillation pathway
Additional pathways for enhanced care coordination include…
  • Rapid access clinic for patients with headache
  • Patients with first onset seizure
  • Pregnancy of unknown location
  • In development: Congestive Heart Failure and Neutropenic Fever pathways

Rapid Diagnostic Centers

Partnership with Immediate Care Centers, Primary Care and the Emergency Department to provide same-day extended diagnostic services in an outpatient setting.

Hospital At Home

Aims to reduce inpatient length of stay and an alternative to facility hospitalization by providing inpatient service to patients in the comfort of their own home.

Academy for Quality and Safety Improvement (AQSI) Projects

2025-2026

Team “Nutritional Privileges Optimized (NPO)”, led by Skyler Kessler and Jilan Shimberg. This team's work focuses on reducing unnecessary NPO time in the Emergency Department and improving patient and provider satisfaction through an Epic track board tool that helps identify patients who should remain NPO and allows appropriate patients to eat and drink during their ED stay.

 

Team “EDvancing Geriatric Interdisciplinary Interventions,” led by Colleen Hogan, with clinical sponsorship from Scott Dresden. This team’s work focused on expanding occupational therapy support for older Emergency Department patients through interdisciplinary education, standardized consultation processes, and dedicated occupational therapy staffing.

 

2024-2025

Team “Nutritional Privileges Optimized”, led by Josh Jonkman, Skyler Kessler and Jilan Shimberg, with clinical sponsorship from Abra Fant and executive sponsorship from Sanjeev Mallik and Maureen Slade. This team’s work focused on reducing unnecessary fasting among Emergency Department patients by establishing criteria for patients who should remain NPO and implementing an electronic health record indicator to communicate NPO status, with the goal of improving patient and provider satisfaction while reducing workflow interruptions.

 

Team “Increasing 1-Hour Sepsis Bundle Compliance in the Emergency Department,” led by Amanda Sery and Robyn Walowski, with clinical sponsorship from Seth Trueger, MD. This team’s work focused on improving timely completion of the one-hour sepsis bundle through a new Epic track board indicator, a streamlined blood culture collection process and department-wide education.

 

2023-2024

Team "No Bored Boarders" led by Wes Richier, including team members Emily Martin, Michelle Hill, Marie Dreyer, Jonathan Chuko with faculty support by Emilie Powell. This team's work focuses on boarding ED patients with delays in oncological patient care due to lack of heme-onc bed capacity.

2022-2023

Team "Focus on POCUS" led by Jim O'Brien with residents Richmond Castillo, Morgan McCarthy, Megan Chenworth with faculty support by John Bailitz. This team's work centered on increased utilization and adoption of point of care ultrasound in the ED.

Team "Fix This Sheet" with residents Adam Payne and Mitch Blenden. This team's project focused on improving medical record uploads of run sheets into for patients transported by EMS.

2021-2022

Team "Stroke of Genius" with residents Andrew Long, Michell Blenden and Pranav Kaul. This team's work focused on improving door to CT times for stroke patients.

Team "To the ED Boarders ICU", with residents Elizabeth Stulpin and Savannah Vogel. This team focused on improving care of boarding ICU patients with the ICU fellows.

2020-2021

Team "Syncope" Led by PGY3 Nick Wleklinski and PGY4 Matt McCauley, this project aims to reduce the use of echocardiograms in low-risk patients by promoting the use of the Canadian Syncope Risk Score via modifying the echocardiogram order in Epic. 

Team "Recharge the Discharge" Led by PGY4 Brett Cohen, the team also includes PGY3's - David Feiger, Chloe Renshaw, Andy Rogers, and Logan Wedel. This team developed a discharge process that is stream-lined for all providers in the department and more geared towards patient satisfaction, including the implementation of "E-prescribing" to decrease pharmacy wait times for our patients

Many of our faculty and residents participate in the Academy for Quality and Safety Improvement (AQSI) projects. Recent projects include:
  • Reducing opioid prescription from the Emergency Department
  • Identifying gender disparities in Emergency Department radiology turn-around-time
  • Improving the evaluation of patients with a head injury and clinical suspicion for a concussion who present to the Emergency Department 
  • Identifying of fragility among elderly trauma surgery patients and implementing interventions to improve outcomes
  • Reducing unnecessary blood culture for CAP, cellulitis, and pyelonephritis 
  • Standardization of sedation usage post-intubation beginning in the Emergency Department and continuing in the MICU
  • Creating a formal protocol for the care of patients with sepsis and septic shock presenting in the Emergency Department
  • Improving the timeliness of care for patients with neurologic emergencies presenting in the Emergency Department
  • Establishing safe and efficacious use of conscious sedation in the Emergency Department

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