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CASE STUDY: Mid-Sized Hospital, Large-Scale Gains – How Changes in Patient Access Drove Financial Success

OVERVIEW

The Emergency Department (ED) at a mid-sized community hospital was facing an emergency of its own – wait times were high, clinician engagement was low, and financial performance was in steep decline. Collectively, these issues were degrading patient outcomes, staff morale, and institutional reputation while simultaneously increasing operational costs. Changes needed to be made, and fast.

To address these challenges, hospital leadership partnered with Core Clinical Partners, a physician-led practice management group, to implement a multi-phase improvement strategy. After implementation, the ED saw significant reductions in clinician turnover and LWBS rates, resulting in measurable financial gains.

THE CHALLENGE

When Core assumed management of the Emergency Department, several problems were negatively impacting both patient care and financial performance:

  • High Left Without Being Seen (LWBS) Rates (4.2%): Patients were leaving after check-in/triage prior to receiving care. High LWBS rates often indicate workflow inefficiencies, particularly with front-end processes.
  • Long Wait Times: Triage bottlenecks and poor patient throughput often resulted in patients having to wait hours to receive care. ED boarding was frequent with little buy-in to interdepartmental accountability for solutions.
  • Workforce Instability: Physician turnover was high and recruitment was ineffective. Contributing to clinician dissatisfaction was inadequate staffing, specifically during peak arrival times – all of this was a recipe for burnout.
  • Limited Clinician Engagement: Physicians and APPs were routinely under the strain of tasks without connection to the broader interdisciplinary team. Culture was suffering. Added to this, there was a clear lack of onboarding and mentorship that are cornerstones of developing strong teams.
  • Poor Financial Performance: The combination of clinician turnover, operational costs, and loss of revenue from high LWBS rates resulted in sub-optimal profitability.

Leadership knew that addressing these issues was essential to improving care delivery, optimizing resource use, and sustaining long-term hospital success.

THE Solution

Core Clinical Partners launched a multi-phase improvement plan, rooted in intentionality, accountability, and efficiency. This process included:

  • Front-end process redesign, including provider-in-triage and streamlined triage protocols, to decrease wait times and LWBS rates.
  • Improved scheduling models, retention incentives, and dedicated onboarding programs to reduce clinician turnover.
  • Pairing of a seasoned ED Medical Director with a Regional Director of Operations to foster growth and develop shared goals.
  • Utilization of chat function available in the EHR to improve cross-departmental communication to assist with discharging patients from the lobby that have had initial testing completed.
  • Real-time feedback systems and monthly performance reviews to sustain results.

THE RESULTS

  • LWBS Rate Reduction: Within 12 months of implementation, LWBS decreased from 4.2% to 0.6%. Arrival to Clinician times also decreased from 25 minutes to 12 minutes.

Solution Graphic

  • Workforce Stabilization: Clinician turnover decreased by 30% – the result of strategic investments in clinician engagement and retention.
  • Decreased Locum Usage: With better clinician retention, hospital leadership did not have to rely on Locum tenens nearly as much. Locum tenens utilization declined from 66 shifts per month to 3 shifts per month – a 95% reduction.

Staffing Distribution Graph

  • Financial Gains: With improved patient throughput, reduced patient walkouts, and reduced clinician expense, the ED saw an increase in net revenue, driven by more billable visits and efficient resource utilization.

THE Takeaway

This transformation reflects what’s possible when a physician group operates as a true strategic partner, and not just a vendor. By restoring stability, strengthening clinician engagement, improving access, and aligning operations with financial performance, Core helped this Emergency Medicine program move from instability to sustained momentum. The result wasn’t volume for volume’s sake; it was disciplined execution, better throughput, stronger clinician and patient experience, and measurable value for the hospital and its community.  

Ready to transform your Emergency Medicine program? Contact us to schedule a strategic assessment with our team.