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CASE STUDY:
EMERGENCY DEPARTMENT
TURNAROUND AMID CRISIS AND GROWTH

OVERVIEW

A community hospital was facing a full-blown emergency—leadership gaps in their physician management group and a shortage of local clinicians was putting patient care in jeopardy. With a Left Without Being Seen (LWBS) rate of 8.8%, 1 of every 11 patients left before receiving care—putting lives at risk and threatening the hospital’s reputation and financial health.

Core Clinical Partners was asked to take over ED operations with just five days’ notice. At the same time, hospital leadership anticipated a 30% surge in patient volume due to the planned closure of a neighboring facility. What followed was a rapid but methodical turnaround—led by Core’s team—focused on flow redesign, data-driven staffing, and frontline clinical engagement.

Within weeks, the department stabilized. Within months, it had transformed into a high-functioning, high-volume ED delivering timely, patient-centered care.

THE CHALLENGE

This wasn’t just a staffing gap—it was a full operational breakdown. With no clinical oversight, no performance monitoring, and no structured workflows, the ED had become reactive and inefficient. The 8.8% LWBS rate was only a symptom of deeper, systemic dysfunction:

  • Patient flow lacked acuity-based differentiation
  • Staffing did not align with real-time demand
  • Critical care resources were diverted to low-acuity patients
  • Moral was low, and frontline teams lacked clarity or confidence

Adding to the urgency was the anticipated 30% surge in patient volume, which required not just recovery—but a solution that could scale quickly and sustainably.

THE SOLUTION

Core responded with a structured, boots-on-the-ground strategy that combined crisis stabilization with long-term systems planning. Within five days, Core was onsite conducting direct observation, engaging with staff, and identifying the biggest pressure points.

Restoring Order: Zoning the ED for Flow

One of the first steps was implementing an acuity-based zoning model that divided the ED into purpose-specific areas:

Zone 1:
High-Acuity/Resuscitation: Stroke, Trauma, Cardiac Emergencies

Zone 2:
Moderate-Acuity: Chest Pain, Abdominal Complaints, Complex Diagnostics

Zone 3:
Low-Acuity/Fast Track: Minor Injuries, Basic Concerns

This structure created parallel workflows that allowed clinicians to operate at the top of their license—while reducing bottlenecks and prioritizing critical patients.

Aligning Resources with Demand

Core implemented advanced demand-capacity modeling that analyzed arrival trends by hour and day, acuity levels, and treatment durations. This real-time data replaced guesswork with precision:

  • Staffing levels were matched to peak hours
  • Schedules were restructured to reflect actual demand patterns
  • The department was able to handle more patients without increasing overall FTEs

The result was better coverage during peak times and more efficient use of existing resources.

Immediate Clinical Contact: Provider-in-Triage (PIT)

Perhaps the most transformative innovation was the introduction of a Provider-in-Triage (PIT) model. A dedicated clinician began evaluating patients the moment they arrived—often before they were assigned a room. This:

  • Initiated diagnostics early
  • Reduced patient anxiety
  • Prevented walkouts by starting care on arrival
  • Shortened total length of stay by having results ready when rooms opened

THE RESULT

Despite the complexity of the situation and the steep increase in patient volume, the ED achieved dramatic improvements:

  • Door-to Clinician Time decreased by 52% from 60 minutes to 29 minutes
  • Daily Patient Arrivals increased 30% from 96 patients to 125 patients
  • LWBS decreased 77% from 8.8% to 2.0%

Additional results included:

  • Hundreds of additional monthly patient visits, driving ~$3.5 million in additional annual revenue
  • Rapid staff adaptation, with clinicians embracing new workflows as improvements—not burdens
  • Improved ED reputation, positioning the hospital as the preferred regional destination for emergency care

WHY IT WORKED

This wasn’t a story of revolutionary tactics or never-before-seen innovation. The turnaround worked because Core focused on what actually matters: putting the right people on the ground to help frontline teams execute the right solutions for their specific challenges.

The strategies, zoning, PIT, demand modeling, are familiar to anyone in emergency medicine. But applying them with speed, clarity, and site-specific precision is what made the difference. Core didn’t hand over a plan and walk away. We were on site, shoulder-to-shoulder with hospital and ED leadership, helping frontline teams move from strategy to sustained results.

Success came from:

  • Real-time GEMBA-based assessments, not assumptions or historic data
  • Acuity-based zoning tailored to space and staffing realities
  • A PIT model that fit the hospital’s flow, culture, and resources
  • Demand-capacity modeling that drove actionable scheduling changes
  • Daily huddles and metric tracking to maintain progress and accountability

Most importantly, Core helped rebuild trust—among clinicians, hospital leaders, and the patients they serve. The result wasn’t magic. It was disciplined, aligned, hands-on work that delivered lasting results.

THE TAKEAWAY

This case study illustrates how hospitals can respond decisively in the face of sudden disruption—and come out stronger on the other side. Core Clinical Partners helped turn an overwhelmed, at-risk ED into a responsive, efficient, and scalable operation. Even under immense pressure, the right partnership and the right systems can create lasting change.

Don’t wait for a crisis to rethink your Emergency Department performance. Contact Core to explore scalable solutions for your hospital’s most critical challenges.