The last thing a parent with a sick or injured child wants to do in the hospital emergency room is wait. 

And continue waiting as anxiety builds.

Working to limit that scenario, Children’s  Hospital of Pittsburgh of UPMC has teamed up with industrial engineers at the University of Pittsburgh’s Swanson School of Engineering to develop ways to reduce emergency-department wait times. 

The team has developed wait-time indicators, which update every 3 minutes, and show length of time before the next treatment room is available. Those times also are posted on the hospital website. At 4:30 p.m. on a recent afternoon, for example, the monitor showed that the next room would be available in 15 to 25 minutes, with a general range of 0 to 50 minutes.

The Pitt team also created a “surge tool” — a computer program that predicts surges in patient volume two hours ahead of time, providing hospital officials time to increase staff size to limit wait time and improve patient flow. 

“There’s no question we’ve made gains in in our processes,” said Richard Saladino, chief of pediatric emergency medicine at Children’s. noting improvements in efficiency. ”We are building a culture where we have even better communication with parents and patients to help take away some of the anxiety that comes along with coming to the emergency department.” 

Put into effect last summer, the system is now in use with regular updates to improve results: “We’re trying to improve service, and we’re in the early stages of doing it,” said Louis Luangkesorn, Pitt’s project coordinator.  

When Children’s was in Oakland, about 60,000 patients a year were treated in its emergency room — a sometimes aggravating experience for families of children with nonlife-threatening conditions who were shepherded through a seemingly endless labyrinth of waiting rooms. Last year, 82,000 pediatric patients were treated at the new hospital in Lawrenceville, Dr. Saladino said — an average of 225 patients a day.

Heather Ambrose, hospital director of nursing, said the emergency department staff includes 23 to 28 nurses and five to 10 patient-care technicians. Dr. Saladino noted that the staff also includes two dozen health providers — physicians, doctors in training, physician assistants and nursing practitioners.

The system, which uses a computer algorithm based on patient volumes in the past, predicts patient totals by hour, day and season, with increases generally anticipated late afternoon on weekdays, with peak numbers in the evening. That occurs for a logical reason, said Mr. Luangkesorn, a Pitt assistant professor of industrial engineering who holds a doctorate in industrial engineering and management sciences.

Typically, a parent returns home from work to discover a sick or ill child. The parent might take the child to the emergency room immediately. But often the parent waits for his or her spouse to arrive home before a decision is made to visit the hospital. That explains why evening typically has peak numbers of patients. 

Dr. Saladino, however, said that patient volume generally is fairly steady from 10 a.m. to 2 a.m.

Pitt’s system is based on registration times for each patient, as compared with the time when treatment begins.

The new system requires a hospital official to log emergency-room population totals every hour, which includes the number of patients in treatment and those still in the waiting room. 

The department has 42 beds. Historically, Mr. Luangkesorn said hospital officials summon additional staff when all 42 rooms are full, with about half that number — another 21 patients — still in the waiting room. That 50 percent excess over capacity was a working number in the Pitt algorithm.  

With increases in emergency-room visits this fall, and peak totals typically occurring during winter months, the newly upgraded formula now provides a surge alert when patient volume is 30 percent higher than room capacity — essentially 13 patients in the waiting room. Adjustments will continue throughout the year, Mr. Luangkesorn said.

“It looks like it’s been successful,” he said. “The summer is not a great time to assess it, but we think waiting time in the fall has been less than the same time last year, with improvements in September and October.”

David Templeton: dtempleton@post-gazette.com or 412-263-1578. Twitter: @templetoons.

First Published: December 5, 2017, 11:30 a.m.