Problem: The call for quality improvement (QI) and practice transformation is increasing attention on the practice of emergency medicine at a national level. E-QUAL identified six focus areas with clinical salience for physician engagement and practice transformation: Sepsis, Avoidable Imaging, Chest Pain, Opioid Harm Reduction, Stroke Care, and Atrial Fibrillation.
Measurement: E-QUAL enrolls emergency departments (EDs) in year-long initiatives in which the ED champion interacts with the E-QUAL virtual portal to report on local quality improvement activities. These include completing the online portal activities, engaging eligible clinicians in local QI projects, utilizing educational toolkits, webinars, podcasts, and submitting benchmarking data.
Analysis: E-QUAL participants provide data in three forms: Survey, Chart Abstraction, and Viewing Educational Content. Due to data being self-reported, analytics are limited to descriptive statistics.
Implementation: Best practices are deployed in various formats such as: toolkits, webinars, workflows, and subject matter work groups to refine QI strategies to be utilized in both rural and urban ED sites. The breadth of E-QUAL’s reach nationwide, provides an elevated view of the challenges impacting emergency medicine.
Results/Discussion: Through engagement of emergency clinicians and leveraging of EDs to improve clinical outcomes, E-QUAL has demonstrated 25,000 lives saved from better sepsis care, 30,000 fewer patients harmed from ionizing radiation, $55 million saved from fewer avoidable imaging and hospitalizations, along with a 35% reduction of opioid prescribing practices.