ROI Metric Examples

  • 4% reduction in patients who leave without being seen (LWBS) = annual return of $2.178M
  • 24% increase in ED revenue due to reductions in patient elopements and diversion =
    annual return of $578K
  • 23% increase in Inpatient revenue through the ED = annual return of $2.4M
  • $400K annual savings in labor costs by matching patient demand to staffing requirements
  • LWBS rate decreased from 3.9% to 1.89%
  • Patient Volume increased 15% with no increase facilities resources (no more ED beds).
    Same RN to patient ratio maintained
  • Average Door to Doctor Time decreased from 45 minutes to 15 minutes


After using a custom Apogee simulation to predict how “Team Triage” would affect patient flow and staffing, we made the decision to implement a new process redesign whereby an MD and a 2nd Triage RN were added to our triage area. After piloting the change for a brief time, it proved the Apogee simulation correct. Our average Door to Doctor time decreased from 45 minutes to 15 minutes. The RN staff was thrilled. The patients are happier with how fast they are being seen. This process improvement initiative cost us much less than the proposed addition of 10 new ED beds. I expect the LWBS rate will drop further not only offsetting the RN FTE cost but adding approximately $300,000 of lost revenue to my bottom line. I made this process change permanent on June 8, 2009.
Brent Lemonds, MS, RN, EMT-P
Administrative Director, Emergency Services & Specialty Nursing, Vanderbilt Medical Center
Several years ago, our tracking board historical data and survey results showed us waiting times were up, length of stay was up, and patients and staff were unhappy. There is no cookie-cutter solution to fix every problem in the ED… We needed to understand capacity and gridlock throughout the hospital and with the help of Apogee, we took the whole process apart and with the simulations we were able to see multiple combinations of process changes under any variation of conditions… By running simulations before piloting an idea we save ourselves from making real mistakes and wasting time on improvements that don’t work.
Denise Mogg, Director of Emergency Services, Saint Luke’s Health System


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