How to Use Teamwork to Transform Your ED (Part 1) (1)

Does your hospital's emergency department (ED) operate like a football team or a basketball team? Here's how to tell the difference.

In football, each player has a narrow skill set and a specific job. The ball changes hands exactly once per play. And after that play is set, little on-field communication takes place.

In an ED context, this means that the physician has one job, the nurse has another, and the hospitalist upstairs yet another. Everyone focuses on their assigned role and rarely invites input from the others. This can result in team members working at cross-purposes, which negatively impacts quality, safety, and efficiency.

By contrast, a basketball team is much more agile. Everyone plays offense or defense as the situation demands. Fluid handoffs and communication drive the game.

In the ED, this means that team members stay in close communication about patients. They help each other carry out the care plan and back each other up during surges or crises. This high-level teamwork can have a tremendously positive impact on the hospital and patients.

Not just a buzzword

The idea of improving ED performance through teamwork may seem obvious and even cliché. But the truth is, EDs driven by strong multidisciplinary teams have a competitive advantage in the era of value-based care.

Perhaps the biggest benefits of teamwork are efficiency and throughput. Processes simply move faster when team members communicate and share the workload. Speeding up the ED almost always leads to improvements in the following:

Quality program performance

Centers for Medicare and Medicaid Services (CMS) evaluates EDs on several time-limited measures (for example, the percentage of chest pain patients receiving fibrinolytic therapy within 30 minutes of hospital arrival). Speed and process efficiency help hospitals to improve their quality scores and maximize their CMS reimbursements.

Patient satisfaction

CMS also ties a percentage of value-based reimbursement to patient satisfaction surveys. Patients who move efficiently through the ED tend to score their care much higher than those who spend hours waiting to be seen.


The faster the ED can admit and discharge patients and turn over beds, the more patients it can serve. This raises hospital revenue both directly and by boosting admissions numbers.

Clinical outcomes

Patients with shorter ED lengths of stay are more likely to receive evidence-based care and less likely to experience complications due to treatment delays.

Fewer walkouts

Each patient who leaves the ED without being seen costs the hospital hundreds of dollars in revenue. Patients who walk out are also at increased risk for complications and may have poorer outcomes. By contrast, walkouts tend to decrease when time-to-provider improves.

Ripple effect

Improving ED throughput tends to improve patient flow across the hospital.

Other benefits

In addition to efficiency gains, teamwork has other advantages for EDs and their hospitals:

  • More than 70 percent of medical errors can be attributed to poor communication. Teamwork is safer for patients, because it keeps the care team on the same page.
  • Staff satisfaction. Teamwork is more satisfying for healthcare workers than operating in rigid hierarchies.
  • Patient experience and loyalty. Communication between providers tends to impress patients and families, further improving patients' satisfaction with their care.

So improving ED teamwork almost always pays off for your hospital and patients. But how do you get there? Stay tuned for next week's continuation of this article, highlighting the processes that have helped foster a culture of teamwork at Vituity's EDs.

To learn more about Vituity's emergency medicine solutions, visit our website.

Originally published July 31, 2018.