Effect of a Nurse Rapid Intake Initiative on Patient Length of Stay and Satisfaction

5.00
Hdl Handle:
http://hdl.handle.net/10755/162365
Type:
Presentation
Title:
Effect of a Nurse Rapid Intake Initiative on Patient Length of Stay and Satisfaction
Abstract:
Effect of a Nurse Rapid Intake Initiative on Patient Length of Stay and Satisfaction
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Boardwine, Arnie, RN, BS, CEN
P.I. Institution Name:Duke University Hospital Emergency Dept.
Title:Nurse Manager of Operations
Contact Address:2301 Erwin Road, DUMC 100100, Durham, NC, 27710, USA
Contact Telephone:919-668-4904
Co-Authors:Frank DeMarco, RN; Alex Limkakeng, MD, FACEP; Charles Gerardo, MD, FACEP; John Villani, MD, PhD; Abhinav Chandra, MD, FACEP; Candance Van Vleet, RN, NREMT-P
[ENA Annual Conference - Research Presentation]

Purpose: A recent Institute of Medicine report has highlighted the crowded state of emergency departments (EDs) nationwide. Many EDs have reported protocols for initiating patient workup in triage. We hypothesized that allotting two patient care beds for a Rapid Intake process would decrease ED length of stay and increase patient satisfaction.

Design: Prospective cohort study with both historical and concurrent control.

Setting: An urban academic level 1 trauma and tertiary care hospital ED with an average annual census of 70,000 visits.

Participants/Subjects: Adult patients presenting over a one month period in April 2009. Patients with the longest waiting room times were selected for Rapid Intake by triage nurses per standard Emergency Severity Index (ESI) protocols. When Rapid Intake was unavailable, patients were brought to a treatment room and received standard care.

Methods: Two patient rooms were allotted for the Rapid Intake process, which allowed for blood draws, electrocardiograms, and ordering of other tests via standing orders by a nurse. Data measured included ED lengths of stay (LOS) in minutes and patient satisfaction scores (as measured by Press Ganey). Groups were compared using Mann-Whitney U test with significance of p<0.05.

Results/Outcomes: There were 1729 patients in the Rapid Intake group compared to the 3288 patients in the standard care group. The overall department median LOS was 350 minutes prior to the intervention and 280 minutes after the intervention (p=0.004). For patients in the Rapid Intake group, LOS was decreased to median 197 minutes compared to 390 minutes for concurrent standard care (p=0.003). Patient satisfaction scores were 85.2 in the Rapid Intake group vs. 83.4 for standard care group.

Implications: Even at the cost of two patient care rooms, a Rapid Intake process resulted in decreased lengths of stay and increased patient satisfaction on an individual level and systemically. This intervention appears useful to increase emergency department throughput and patient satisfaction.
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.titleEffect of a Nurse Rapid Intake Initiative on Patient Length of Stay and Satisfactionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162365-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Effect of a Nurse Rapid Intake Initiative on Patient Length of Stay and Satisfaction</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">Boardwine, Arnie, RN, BS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Duke University Hospital Emergency Dept.</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Manager of Operations</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2301 Erwin Road, DUMC 100100, Durham, NC, 27710, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">919-668-4904</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Board001@mc.duke.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Frank DeMarco, RN; Alex Limkakeng, MD, FACEP; Charles Gerardo, MD, FACEP; John Villani, MD, PhD; Abhinav Chandra, MD, FACEP; Candance Van Vleet, RN, NREMT-P</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Research Presentation] <br/><br/>Purpose: A recent Institute of Medicine report has highlighted the crowded state of emergency departments (EDs) nationwide. Many EDs have reported protocols for initiating patient workup in triage. We hypothesized that allotting two patient care beds for a Rapid Intake process would decrease ED length of stay and increase patient satisfaction. <br/><br/>Design: Prospective cohort study with both historical and concurrent control. <br/><br/>Setting: An urban academic level 1 trauma and tertiary care hospital ED with an average annual census of 70,000 visits. <br/><br/>Participants/Subjects: Adult patients presenting over a one month period in April 2009. Patients with the longest waiting room times were selected for Rapid Intake by triage nurses per standard Emergency Severity Index (ESI) protocols. When Rapid Intake was unavailable, patients were brought to a treatment room and received standard care. <br/><br/>Methods: Two patient rooms were allotted for the Rapid Intake process, which allowed for blood draws, electrocardiograms, and ordering of other tests via standing orders by a nurse. Data measured included ED lengths of stay (LOS) in minutes and patient satisfaction scores (as measured by Press Ganey). Groups were compared using Mann-Whitney U test with significance of p&lt;0.05. <br/><br/>Results/Outcomes: There were 1729 patients in the Rapid Intake group compared to the 3288 patients in the standard care group. The overall department median LOS was 350 minutes prior to the intervention and 280 minutes after the intervention (p=0.004). For patients in the Rapid Intake group, LOS was decreased to median 197 minutes compared to 390 minutes for concurrent standard care (p=0.003). Patient satisfaction scores were 85.2 in the Rapid Intake group vs. 83.4 for standard care group.<br/><br/>Implications: Even at the cost of two patient care rooms, a Rapid Intake process resulted in decreased lengths of stay and increased patient satisfaction on an individual level and systemically. This intervention appears useful to increase emergency department throughput and patient satisfaction.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:26:56Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:26:56Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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