'Pull to full' speeds up flow.

The ED at Carolinas Medical Center-Union, Monroe, NC, has implemented several processes and strategies in recent years that have earned it recognition for service excellence. Some of those strategies are: when beds are available,"pulling"patients straight to the back and performing triage in the room; introducing point of care devices for troponin, which cut 40 minutes off diagnostic time; creating a spreadsheet that tracked length of stay and patients leaving without being seen, broken down by shift.