Front-Line Driven Innovation: Vituity's ED Throughput Collaborative [Video]

Published January 08, 2019

vituity ed throughput learning collaborative


Vituity ED throughput collaborative

No sooner had the emergency department (ED) team at Swedish Edmonds (Wash.) moved into a new facility, their patient volumes began to climb. They needed to act fast to relieve crowding and reduce wait times — all while adapting to a new floor plan and workflow.

To explore new solutions, the team joined Vituity's ED Throughput Learning Collaborative. This innovative 9-month program helps departments around the country to quickly improve processes and implement best practices. By the end of the collaborative, Swedish Edmonds had improved it's ED throughput by 27 minutes — even as patient volumes continued to rise.

To hear Swedish Edmonds' story in the words of team members, watch the video or read the transcript below.

Vituity brings collaborative learning opportunities to like-minded health systems across the country. This is a unique opportunity to find support and innovation with your hospital leadership and clinical colleagues. If you’re interested in being part of Vituity’s 2019 Collaborative Series, please email


Location: Swedish Edmonds Emergency Department (Wash.)


  • Gregg Miller, MD, Chief Medical Officer, Vituity
  • Brian Mitchell, RN, Emergency Nurse, Swedish Edmonds
  • Jeremy Hammel, MD, Emergency Department Medical Director, Vituity
  • Devin Ball, RN, Emergency Department Supervisor, Swedish Edmonds
  • Mike Hastings, RN, Emergency Department Manager, Swedish Edmonds
  • Jean Doerge, RN, MBA, Nurse Executive, Swedish Edmonds

Gregg Miller: Vituity's culture is all about innovation and collaboration, and we use that to really transform the care that we deliver across the United States. One way we innovate is through our collaborative model, which is a great opportunity for all types of providers from the healthcare environment to get together in a room. We involve doctors, we get nurses, advanced providers, healthcare administrators, lab personnel, registration, radiology, whoever is important.

Brian Mitchell: We [at Swedish Edmonds] have a new [ED] building that's approximately two-and-a-half years old now. There were a lot of growing pains that came along with this building, which was bigger and a different design, different efficiency.

Jeremy Hammel: There were changes in the layout out of the emergency department. Things didn't flow quite the same way as they did before.

Devin Ball: We wanted to come up with a way to improve the throughput of our department to get our patients seen much quicker and get their treatment started so that we could have better outcomes and decrease length of stay as much as possible.

Mike Hastings: It's always a stressful time on your staff when you have higher volumes than you typically see. We were seeing about 30 to 40 patients a day additionally beyond our historical baseline.

Jean Doerge: The Vituity [ED Throughout] Collaborative presented an opportunity for us to learn how to do our work differently. It created a chance for people to work together and do some design work, which is sometimes hard to do in the midst of the busy, day-to-day responsibilities that we have.

Jeremy Hammel: Even though all the sites [participating in the collaborative] were different with different volumes and challenges, there were also common threads. Sometimes a team would get up and present the ideas they'd come up with, and all of us around the table would look at each other like, "Hey, we could use that," or "We could implement something similar at our site."

Jean Doerge: The results are exciting. We know that for the more than 50,000 patients served [during the collaborative], we've reduced their wait time and their throughput time significantly. And that's what it's all about: great customer service.

In January 2017, volumes were up 5 percent. However, turnaround time to discharge was down 27 minutes (12.5 percent).

Gregg Miller: We've seen significant improvements in productivity. We've seen improvements in throughput. We've seen improvements in patient experience. We've seen improvement in readmissions. We know that this is a model that works, and that's why we're continuing to invest in this.

Brian Mitchell: The Vituity partners provide a lot of support for us, but they don't micromanage. They offer support where it's needed, but they also know that you [the nurses] know your facility best. I've heard many of them say that.

Jeremy Hammel: It's so helpful to have the specialized personnel that Vituity made available to us: the practice management consultants and some of the data people who helped us actually put together the sheets to track what we were doing. Those are not always the sort of skill sets that we would have at the local level.

Gregg Miller: We save lives. That's our job, right? We don't know how to actually manage a program or manage a project, and so a collaborative really brings that skill set and a real sense of organization. And that increases the ability of these sites to really implement change and hard-wire that change once the initiative's over.

Brian Mitchell: With Vituity putting in as much effort as they have to back this, between their time and their resource investments, just shows me that they're in this as well.

Mike Hastings: They've been a phenomenal group to work with, and I'm glad that I'm here and that they're here with me.

Devin Ball: Having the support and strength of Vituity behind me makes my job easier. They help me to support my staff and patients.

Jean Doerge: Solutions come from the frontline, and solutions come from people that know their work and know what's needed. The collaborative helps us put together frontline thinking and solutions and do some rapid redesign and measure our results. I think that's the essence of how we change, how we transform, and how we improve.

Gregg Miller: Vituity's culture really is a collaborative culture. It's a culture of partnership. And so I think that's our DNA. We want a partner, we want to work with everybody on the team.

When we give the teams these tools, it's amazing what'll happen. You just step back and let people loose. Beautiful things happen at our sites when they engage with the collaborative.

Vituity brings collaborative learning opportunities to like-minded health systems across the country. This is a unique opportunity to find support and innovation with your hospital leadership and clinical colleagues. If you’re interested in being part of Vituity’s 2019 Collaborative Series, please email

Originally published Jan. 8, 2019.

Partnering to improve patient lives

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