2.50
Hdl Handle:
http://hdl.handle.net/10755/162356
Type:
Presentation
Title:
Keys to the Gate: Unlocking Emergency Department Patient Flow
Abstract:
Keys to the Gate: Unlocking Emergency Department Patient Flow
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Zeigler, Joan, RN, CEN
P.I. Institution Name:St. Mary Medical Center
Title:RN-Clinical Team Leader
Contact Address:1201 Langhorne-Newtown Road, Langhorne, PA, 19047, USA
Co-Authors:Michele Orzehoski, RN, BSN, CEN
Leadership Conference - Evidence-Based Practice Abstract: Keys to the Gate: Unlocking Emergency Department Patient Flow

Purpose: ED overcrowding has presented significant issues for patient care, as well as patient and staff satisfaction. In an effort to reduce length of stay and facilitate patient flow, a multidisciplinary committee was formed. Representatives from critical care, telemetry and medical/surgical nursing met to address the reduction of patient time spent in the ED from assignment of the inpatient bed to transportation to that bed. Retrospective data revealed that only 25% of admitted patientsÆ reports were given to inpatient nurses within 15 minutes of bed assignment. Furthermore, only 8% of those patients were transported to the inpatient bed within the next 15 minutes. The goal of this process was to increase those numbers to 60% and 50% respectively.

Design: This was quality improvement project. Staff conducted weekly retrospective chart review measuring in minutes the amount of time elapsed from inpatient bed assignment of the ED patient to when hand-off report was given and when transport to the inpatient bed was achieved. These median times were calculated weekly with the data disseminated to all parties involved.

Setting: Suburban Mid-Atlantic Level II Trauma/Community Medical Center, 50 bed Emergency Department, 360 inpatient beds. This facility sees over 60,000 patients per year with approximately 60% of inpatient admissions being admitted through the ED

Participants: Process improvements were enacted by all ED and inpatient nurses in January, 2008. These have continued and are currently active. This abstract addresses the calendar year 2008.

Methods: Multi-unit collaboration was achieved and rapid cycle change methods were used to address the admission process, specifically the bed assignment to transport times. An intervention bundle was developed including: ED and inpatient ôswim lanesö, SBAR format report sheet, SBAR format checklist for ED report, standardized inpatient unit admission processes and a telemetry admission transport process. Hospital wide education sessions were performed by the process facilitators regarding all processes and changes to be implemented. The bed to report and report to transport times were continuously measured throughout the year. Specific metrics were calculated pertaining to individual ED nurse and inpatient unit average times.

Results: The data measured in January 2009 revealed an improvement from 25% to 59% of ED admitted patients had SBAR report given to the inpatient floor within 15 minutes of bed assignment. In addition, an increase from 8% to 40% of ED admitted patients were transported to their inpatient beds within 15 minutes of report being given. Each ED nurse has also seen a decrease in their individual time from bed to report since enacting the process by as much as 24 minutes.

Implications: Overall reduction in ED length of stay has been directly linked to decreased ED crowding, reduced ambulance diversion and increased patient satisfaction. The reduction of elopements, patients who have left without treatment, and ED wait times increases patient satisfaction and potential revenue. In addition, the ED is able to see more patients due to lower incidences of crowding and decreased wait times.



Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleKeys to the Gate: Unlocking Emergency Department Patient Flowen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162356-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Keys to the Gate: Unlocking Emergency Department Patient Flow</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Zeigler, Joan, RN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Mary Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">RN-Clinical Team Leader</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1201 Langhorne-Newtown Road, Langhorne, PA, 19047, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Zigsmom774@aol.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Michele Orzehoski, RN, BSN, CEN</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: Keys to the Gate: Unlocking Emergency Department Patient Flow<br/><br/>Purpose: ED overcrowding has presented significant issues for patient care, as well as patient and staff satisfaction. In an effort to reduce length of stay and facilitate patient flow, a multidisciplinary committee was formed. Representatives from critical care, telemetry and medical/surgical nursing met to address the reduction of patient time spent in the ED from assignment of the inpatient bed to transportation to that bed. Retrospective data revealed that only 25% of admitted patients&AElig; reports were given to inpatient nurses within 15 minutes of bed assignment. Furthermore, only 8% of those patients were transported to the inpatient bed within the next 15 minutes. The goal of this process was to increase those numbers to 60% and 50% respectively. <br/><br/>Design: This was quality improvement project. Staff conducted weekly retrospective chart review measuring in minutes the amount of time elapsed from inpatient bed assignment of the ED patient to when hand-off report was given and when transport to the inpatient bed was achieved. These median times were calculated weekly with the data disseminated to all parties involved. <br/><br/>Setting: Suburban Mid-Atlantic Level II Trauma/Community Medical Center, 50 bed Emergency Department, 360 inpatient beds. This facility sees over 60,000 patients per year with approximately 60% of inpatient admissions being admitted through the ED <br/><br/>Participants: Process improvements were enacted by all ED and inpatient nurses in January, 2008. These have continued and are currently active. This abstract addresses the calendar year 2008.<br/><br/>Methods: Multi-unit collaboration was achieved and rapid cycle change methods were used to address the admission process, specifically the bed assignment to transport times. An intervention bundle was developed including: ED and inpatient &ocirc;swim lanes&ouml;, SBAR format report sheet, SBAR format checklist for ED report, standardized inpatient unit admission processes and a telemetry admission transport process. Hospital wide education sessions were performed by the process facilitators regarding all processes and changes to be implemented. The bed to report and report to transport times were continuously measured throughout the year. Specific metrics were calculated pertaining to individual ED nurse and inpatient unit average times.<br/><br/>Results: The data measured in January 2009 revealed an improvement from 25% to 59% of ED admitted patients had SBAR report given to the inpatient floor within 15 minutes of bed assignment. In addition, an increase from 8% to 40% of ED admitted patients were transported to their inpatient beds within 15 minutes of report being given. Each ED nurse has also seen a decrease in their individual time from bed to report since enacting the process by as much as 24 minutes. <br/><br/>Implications: Overall reduction in ED length of stay has been directly linked to decreased ED crowding, reduced ambulance diversion and increased patient satisfaction. The reduction of elopements, patients who have left without treatment, and ED wait times increases patient satisfaction and potential revenue. In addition, the ED is able to see more patients due to lower incidences of crowding and decreased wait times. <br/><br/><br/> <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:26:44Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:26:44Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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