Case Studies

CEP America Delivers Quality Urgent Care at Kaweah Delta

Kaweah Delta Health Care District

Hospital Beds 454
Annual ED Visits 85000
ED Beds 40

The Kaweah Delta Health Care District’s has experienced a surge of patients to its emergency department (ED) in recent years. In 2012, the ED treated over 85,000 patients and that number is only expected to grow. As ED visits have increased, CEP America’s ED providers noticed an increase in the number of patients who are utilizing the ED for sub-acute care. Recognizing the burden this places on the ED and the hospital at large, Kaweah Delta’s administration turned to CEP America to manage the Kaweah Delta Urgent Care Center (UCC) in California’s Central Valley. 

Previously wait times at Kaweah Delta UCC were long and the hospital was considering shutting it down. John Leal, RN, nurse manager at Kaweah Delta UCC, recalls working together with CEP America to map out patient care requirements and patient time metric goals, spelling out “how they would define greatness.”
The CEP America providers worked with existing staff to identify the fundamental missions of the UCC:
  • To help patients feel better as soon as possible;
  • To transition patients quickly to any additional services they may need;
  • To increase access to medical care for low-income and low-acuity patients who do not have a primary care physician; and,
  • To make sure that the ED is not overwhelmed by demand.  
In order to maximize efficiency and meet the challenge of rapid identification and transport of patients in imminent danger, CEP America worked with the Kaweah team to improve their operations, including clearly defining “back end” and “front end” processes. On the front end, once rooms are full, the nursing staff takes vital signs in the lobby in the first eight minutes after the patient arrives. This identifies patients who require rapid transfer to the ED and frees up back end staff to perform more complex procedures.

After focusing on operations, the CEP America providers turned their attention to encouraging patients with less severe injuries or illnesses to seek treatment in the UCC rather than the ED, relieving the hospital of a major financial burden. According to the hospital, the average cost to the hospital per patient seen in the ED is 30% more than in the UCC, which includes the costs of supplies and all non-physician staffing. Promoting the range of services offered in the UCC decreases pressure on the ED, but also provides a lower-cost option for patients who may not be able to afford care. But the efficiencies at this UCC and the high cost of providing care in the ED make diverting even nonpaying ED patients to the UCC a money-saver for Kaweah Delta Health system. As a county healthcare facility, this is especially important for Kaweah Delta.
The combined efforts between Kaweah Delta’s ED and UCC have proven incredibly successful. Between 2010 and 2012, ED volume continued to grow by 10 percent but the UCC saw its volume increase by 43 percent; seeing nearly 48,00 patients in 2012 alone. The UCC would not have been able to handle the volume increase without the operational improvements made by CEP America early on. The result: on average, patients see a provider within 20 minutes of arrival and spend less than 45 minutes in the UCC from door-to-discharge.

Leal says that the staff at Kawaeh Delta UCC takes a great deal of pride in having treated such a large number of patients in recent years. He says, “It’s hard for me to imagine life without CEP America in this busy center.”