On March 12, 2026, the South Dakota Association of Healthcare Organizations (SDAHO) hosted an engaging presentation titled “Minutes Matter: Inside a High Throughput Emergency Department.” The session featured Tom Olson, ED/Trauma Coordinator, and Connie Andrews, Quality Integration, both from Coteau des Prairies Healthcare System, a 25-bed critical access hospital located in Sisseton SD. Coteau des Prairies sees approximately 4,866 patients in their emergency department annually, and about 405 patients a month. Michelle Jury, RN, Quality Improvement Consultant at SDAHO facilitated the session.
Jury began the session, highlighting the Medicare Beneficiary Quality Improvement Program (MBQIP) and specifications and goals around Median Time from ED Arrival to Departure for Discharged ED Patients, a core measure of the program, with a benchmark of around 85 minutes. Nationally, the median time is 113 minutes, with South Dakota’s median time at 110 minutes, based on 2024-2025 data. “Reducing time patients are in the ED not only can improve access to care, but it can also increase quality of care and patient satisfaction. South Dakota performs better than the nation on average, but there is still improvement that can be made as we strive for the benchmark of 85 minutes,” Jury said.
During the presentation, attendees identified some common challenges around ED Throughput such as:
- bed availability at a higher level of care
- long distance for transfers
- relying on external EMS
- providers off site
- ancillary delays
- limited inpatient capacity
- radiology read times
- behavioral health transfers.
Olson and Andrews shared the strategies that have allowed their rural critical access hospital to achieve exceptional efficiency in emergency care. Some of the strategies include:
- providers in-house 24 hours a day
- using e-emergency to help providers streamline care
- nurses draw and process labs when needed
- talking with providers about expectations and what can be done to help, creating a good working relationship
- EMS crews attending hospital ED department meetings
- creativity with ride share services such as using the local police department when needed
The median throughput time at Coteau des Prairies in 2024 was 53 minutes, 30 minutes faster than the nation. The innovative approaches and focus on optimizing processes led Coteau des Prairies Healthcare System to be recognized in Beckers Hospital Review as one of the nation’s top 10 hospitals for ED throughput times.
Attendees left with practical insights into workflow improvements, staff coordination, and quality integration strategies that can be applied in both rural and larger hospital settings.
SDAHO continues to provide valuable opportunities for health care professionals to learn and implement best practices that improve patient care and outcomes. For more information on the MBQIP program or the Median Time from ED Arrival to Departure for Discharged ED Patients measure, contact Michelle Jury at michelle.jury@sdaho.org.
