Reducing LWBS: How Peaks EDs Keep Patients Seen and Safe

By Jenny Nailling, Manager Internal Communications_COFR

When patients arrive at an emergency room, they’re often at one of the most vulnerable moments of their lives. They're looking for help, reassurance, and answers. And most of the time, they don't want to wait.

Emergency departments (EDs) face immense pressure to meet these expectations while managing high volumes, limited space, and complex care needs. Balancing speed with safety and compassion is no small task, and that’s where the metric known as LWBS, or “Left Without Being Seen,” becomes especially important.

LWBS is one metric within a broader set of components that assess ED efficiency and patient experience. It can also reflect how well an ED is able to provide timely care. Every patient who leaves before being seen represents a missed opportunity to intervene, a potential risk to their health, and a signal that something in the system didn’t meet their needs. 

"Patients who leave without being seen may have serious, untreated conditions and often return with worsened symptoms. Reducing LWBS improves patient safety, satisfaction, and even hospital reputation,” said Sara Taylor, director of Emergency Department, Behavioral Health, Clinical Decision Unit & Sepsis at St. Mary’s Regional Hospital.

St. Mary’s and several other hospitals across the Peaks Region have implemented strategies that are not only lowering LWBS rates but also improving patient experience and caregiver engagement. 

At St. Mary’s, a major shift in care delivery has helped drive LWBS down to 1.2% — the lowest of the year for the ED. Sara Taylor credits the transition to a pod-based nursing model that they launched in June. Instead of one RN being assigned four rooms, the ED is divided into pods staffed by two nurses overseeing eight rooms. 

“This was a helpful suggestion from the ED professional governance team, and we’re thankful it was supported by leadership,” Sara said. “This structure promotes teamwork and flexibility. If one nurse is tied up, the other can jump in to help, preventing delays and improving throughput,” she shared. “We’ve also seen our caregiver engagement scores rise, which I believe is tied to more efficient processes and less frustration.” 

At Platte Valley Hospital, ED manager Jessica Weaver and her team have kept LWBS at a low 0.9% despite continued increases in daily volumes. Their approach centers on proactive communication and patient engagement. 

“We strive to update patients regularly on their progress in the ED,” Jessica said. “We let them know what they’re waiting on and how long it’s expected to take. We also round on patients in the waiting room, post average wait times, and use nurse-initiated orders to start treatment early.”

Jessica believes that every patient who walks into the ED deserves to feel heard and cared for. “If a patient comes to the ED, we should assume they’re facing what they consider an emergency. If patients feel safe and cared for, they’re more likely to recommend our facility to their loved ones.” 

At Good Samaritan Hospital, the ED has maintained impressively low LWBS rates throughout 2025, with monthly percentages dropping as low as 0.25%. Marian Dirks, director of Emergency Services, attributes this success to a renewed focus on immediate patient rooming.

“We’ve implemented a ‘pull ’til full’ process, which is common in most EDs” Marian said. “If there’s an open room, the patient is brought back immediately and triaged in the room. This allows staff to complete vital signs, ask questions, and begin care without delay. Emergency rooms are busy, but every patient deserves to be treated when needed.”

Good Sam’s commitment to timely, compassionate care is also reflected in its patient experience scores. “Our ED has the highest Likelihood to Recommend (LTR) score in the Peaks Region,” Marian said. “We’re proud to know that our patients appreciate the care they receive from our providers. We are here for them at what could be the worst time in their lives, and we want them to know we care.”

All three leaders agree that improving LWBS is about more than numbers — it’s about delivering compassionate, timely care when patients need it most.