Scorecard Tool 7 - ED Metrics Score Card - D2D Split Flow Improvement Analysis

Sep 12, 2026

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ED Metrics Scorecard Tool 7 supports performance monitoring and improvement targeting D2D split flow. The scorecard evaluates four ED outcome measure groups: PATIENT SAFETY through Door to Doc (D2D) times and LWOT volumes, THROUGHPUT via arrivals, admits, and duration metrics, SATISFACTION using patient and staff scores, and BUSINESS LOSS through LWOT lost net income and diversion hours. Monthly data tables include door-to-doc frequency distribution, average waits, visit volumes, LOS/LOU/LOH/LOT, holding capacity, and satisfaction indicators.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages12

Reading Time4 min

AccessFree to download

Analysis Goals

PATIENT SAFETY: Door to Doc (D2D) and LWOT

THROUGHPUT: Arrivals, Admits, and Duration

SATISFACTION: Patient and Staff

BUSINESS LOSS: LWOT and Diversion

Tool 7 Data

D2D, LWOT, and Volumes

Duration Times and Boarding

Satisfaction and Business Loss

The EXCEL® Tool 7

ED Metrics Score Card Template

Scorecard Tool Steve Kisiel, MS Vince Placido, BSE Jeffery K. Cochran, PhD James R. Broyles, BSE Analysis Goals • With this tool, the user will be able answer the question: “Is my ED achieving and maintaining D2D split flow improvement?” • This analysis is based on four key ED performance measure groups: – PATIENT SAFETY: Door to Doc (D2D) times and patients that Leave Without Treatment (LWOT) – THROUGHPUT: arrivals, admits, and portions of patient stay duration times – SATISFACTION: patient and staff – BUSINESS LOSS: LWOT and diversion hours Tool 7 Data – D2D, LWOT, and Volumes | Metric | January | February | | --- | --- | --- | | Door to Doc Frequency Distribution | | | | % < 0-30 min | 9% | 8% | | % < 31-60 min | 17% | 16% | | % < 61-90 min | 13% | 13% | | % > 91 min | 61% | 63% | | Average Door to Doc Time (min) | 167 | 172 | • Door to Doc Times by month – Frequency Distribution = Percent of visits seen in 0-30 min, 31-60 min, 61- 90 min and greater than 91 minutes, as measured from time of arrival to time the ED physician or physician extender first examines the patient. – Average wait time from initial arrival in the ED to time of physician exam. | Metric | January | February | | --- | --- | --- | | Visit Volumes | | | | Total Visits (with LWOTs) | 7,755 | 7,346 | | Total Visits (without LWOTs) | 6,677 | 6,106 | | % of LWOTs | 13.8% | 16.9% | | % of ED Patients Admitted | 27% | 27% | • Visit Volumes by month – % of LWOT = Percent of patients who leave without treatment. Calculated: LWOTs/total visits (with LWOTs) . – % of ED Patients Admitted = Percent of ED patients admitted to the hospital of the ED the patient visited. Calculated: total number of admitted patients/total visits (without LWOTs) . Tool 7 Data-Duration Times and Boarding | Metric | January | February | | --- | --- | --- | | Process Event Times | | | | Length of Stay (LOS) (average min/patient) | 394 | 403 | | Length of Use (LOU) (average min/patient) | 152 | 151 | | Length of Test or Treatment (LOT) (average min/patient) | | | | Admitted Length of Hold (LOH) (average min/patient) | 106 | 106 | • Process Event Times by month – LOS = Average length of stay for all patients (from time of arrival to discharge) – LOU = Average time between bed entrance and disposition or decision – LOH = Average time between disposition or decision to ED discharge – LOT = Average time between first test request or start of treatment (eg. hydration) to last test interpretation or end of treatment | Metric | January | February | | --- | --- | --- | | In-patient Holds | | | | Total Hours of Holds | 8,236 | 7,214 | | Total Bed Capacity/Day (hours) | 1,128 | 1,128 | | Holding as a Percent of Total Bed Capacity | 24% | 23% | • In-patient Holds by month – Hours of bed hold (bed boarding), total bed-hours (capacity) offered. Calculate: Hold Hours / Bed Capacity Hours. Tool 7 Data-Satisfaction and Business Loss | Metric | January | February | | --- | --- | --- | | Satisfaction Scores | | | | Patient Satisfaction | 72.6 | 77.7 | | Staff Satisfaction | 3.45 | 3.45 | • Satisfaction Scores by month – Patient Satisfaction scores usually available monthly. – Staff Satisfaction scores as available, often quarterly or annually. | Metric | January | February | | --- | --- | --- | | Other Statistics | | | | LWOT "Lost" Net Income | $596,070 | $688,200 | | Diversion Hours | 78 | 113 | • Other Statistics include Business Loss by month – LWOT “Lost” Net Income = Potential net income lost due to patients who leave without treatment: LWOTs* ED outpatient average net revenue. – Diversion Hours: Number of hours that ambulances were turned away. The EXCEL® Tool 7 | ED Metrics Score Card | | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Hospital Name and Year Printed Here | | | | | | | | | | | Metric | Target | January | February | March | Q1 | April | May | June

FAQs

What question does Tool 7 help the user answer?

Tool 7 helps determine whether the ED is achieving and maintaining D2D split flow improvement.

Which four ED performance measure groups are included in the analysis?

The scorecard covers PATIENT SAFETY, THROUGHPUT, SATISFACTION, and BUSINESS LOSS.

How are LWOT and diversion related to business loss in Tool 7?

LWOT lost net income estimates potential revenue lost when patients leave without treatment, and diversion hours measure the number of hours ambulances were turned away.

Sep 12, 2026

Upload by Mia