InstaCare brings shorter wait times, improved patient satisfaction

Baltimore Washington Medical Center has launched an innovative model of care that has changed the face of emergency medicine in the Baltimore Washington corridor. By implementing a new revolutionary care system – InstaCare – wait times are minimized and ambulance diversion hours have almost been eliminated.

The new system reduces delays and streamlines key ancillary processes to create a system in which providers can consistently see patients within minutes of arrival. The bold step shortens wait times, improves patient satisfaction and opens up beds for the sickest of patients.

Baltimore Washington Medical Center’s Emergency Room is the largest ER ever to institute InstaCare and only the third one in the country to do so. 

Here is how InstaCare works:  InstaCare runs 24 hours a day, seven days a week. The cornerstone of the concept is the Immediate Provider Evaluation (IPE) system. This system allows clinical decisions to happen at the beginning of patient care, decreasing waiting times, lowering turnaround times and facilitating quicker access to physician care.

Under a traditional model of care, patients typically fell into three categories – those with minor or “urgent care” problems, those with serious acute problems such as a stroke or heart attack, and finally, everyone else. Those patients in the first two categories were generally cared for quickly. But patients who were in the middle often required significant evaluations to determine the reason for their ER visit and the right course of treatment. Often, these were the patients who endured extremely long waits.

The BWMC emergency room has seen tremendous growth in the past six years. In 1999, a new ER opened with the ability to treat 60,000 patients. But in a short time, patient numbers were exceeding capacity. By 2004, the department was treating an average of 219 patients a day – about 80,000 a year. Inevitably, as the patient numbers grew, so did ER wait times.

To implement InstaCare, a multi-disciplinary team of medical center staff, including ER registrars, ER clerical support, lab technicians and radiology staff, completely restructured the ER system, changing everything from the way patients are greeted to the time in which they are treated. Another major change: Instead of registering first, patients now register on their way out the door.