2.50
Hdl Handle:
http://hdl.handle.net/10755/162404
Type:
Presentation
Title:
Work SMARTer, Not Harder : Systematic Methods Achieving Rapid Transformation
Abstract:
Work SMARTer, Not Harder : Systematic Methods Achieving Rapid Transformation
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Russe, Christine, RN, MSN, CEN, CPEN
P.I. Institution Name:Texas Health Presbyterian Hospital Plano
Title:Clinical Education Specialist Emergency Department
Contact Address:6200 West Parker Road, Plano, TX, 75093, USA
Contact Telephone:972-981-8544
Co-Authors:Jody Bauer RN, BSN; Nancy Dooley RN, BSN; Judy Walsh PhD, RN
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: The problem is the emergency department's (ED) overall patient satisfaction
score was in the 36th percentile and the average patient's length of stay (LOS) exceeded three hours. The average time to physician evaluation was 78 minutes which included a detailed triage process. The purpose of this project was to evaluate the effectiveness of the patient throughput process of Project SMART (Systematic Methods Achieving Rapid Transformation) by utilizing best practice methods.

Design: A quality assurance project using application of evidence-based nursing practice.

Setting: This project was conducted in a 52-bed ED in active pursuit of level 3 trauma
designation with 41,000 annual visits in a south central community hospital.

Participants/Subjects: Participants included all registered ED patients during an eleven month period.

Methods: In January 2009, a core group of ED staff, in conjunction with a national
consulting company, worked to implement best practices in the ED. This joint venture was named "Project SMART". Processes and interventions included team-based patient care, a refined rapid triage process, and implementation of a "30 minute promise" that patients would be evaluated by an ED physician within 30 minutes of arrival. Additionally, monitoring of objective time-stamped daily and weekly KPI (key performance indicators) thresholds were examined and included: 1) triage begin to triage complete, 2) triage complete to ED bed placement, 3) ED bed placement to MD evaluation, 4) arrival to bed placement, and 5) arrival to departure (LOS).

Results/Outcomes: Project SMART resulted in patient satisfaction scores soaring from
the 36th percentiles to the 95th percentile while the average patient LOS significantly decreased by almost one hour. The left-without-being-seen rate decreased from 2% to 0.13%.

In November 2008 (Phase 1), prior to the implementation of Project SMART, the ED's LOS averaged 204 minutes. A KPI LOS goal of 149 minutes was defined and in November 2009 the average LOS was decreased to 144 minutes. Phase 1 showed an initial arrival to bed placement of 52 minutes. A KPI of 14 minutes was predetermined and in November 2009 the average arrival to bed placement was reduced to 9 minutes. Phase 1 revealed that the triage process was 7-14 minutes. A KPI of 4 minutes was defined and in November 2009 the average triage process declined to 4 minutes. In Phase 1, the triage complete to ED bed placement averaged 30 minutes. A KPI of 4 minutes was defined and in November 2009 the average triage complete to bed placement was reduced to 2 minutes. The bed placement to MD evaluation averaged 41 minutes. A KPI of 8 minutes was defined and the time to bed placement to MD evaluation averaged 2 minutes, consequently contributing to meeting the goal of the "30 minute promise" to the community 95% of the time and decreasing the patient's overall LOS.

Implications: The implementation of best practices by decreasing patient wait time,
reducing LOS, and promoting the "30 minute promise" has significantly increased patient satisfaction due to accelerated patient throughput.
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.titleWork SMARTer, Not Harder : Systematic Methods Achieving Rapid Transformationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162404-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Work SMARTer, Not Harder : Systematic Methods Achieving Rapid Transformation</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">Russe, Christine, RN, MSN, CEN, CPEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Texas Health Presbyterian Hospital Plano</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Education Specialist Emergency Department<br/></td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6200 West Parker Road, Plano, TX, 75093, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">972-981-8544</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">christinerusse@texashealth.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jody Bauer RN, BSN; Nancy Dooley RN, BSN; Judy Walsh PhD, RN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation] <br/><br/>Purpose: The problem is the emergency department's (ED) overall patient satisfaction <br/>score was in the 36th percentile and the average patient's length of stay (LOS) exceeded three hours. The average time to physician evaluation was 78 minutes which included a detailed triage process. The purpose of this project was to evaluate the effectiveness of the patient throughput process of Project SMART (Systematic Methods Achieving Rapid Transformation) by utilizing best practice methods.<br/><br/>Design: A quality assurance project using application of evidence-based nursing practice. <br/><br/>Setting: This project was conducted in a 52-bed ED in active pursuit of level 3 trauma <br/>designation with 41,000 annual visits in a south central community hospital. <br/><br/> Participants/Subjects: Participants included all registered ED patients during an eleven month period. <br/><br/>Methods: In January 2009, a core group of ED staff, in conjunction with a national <br/>consulting company, worked to implement best practices in the ED. This joint venture was named &quot;Project SMART&quot;. Processes and interventions included team-based patient care, a refined rapid triage process, and implementation of a &quot;30 minute promise&quot; that patients would be evaluated by an ED physician within 30 minutes of arrival. Additionally, monitoring of objective time-stamped daily and weekly KPI (key performance indicators) thresholds were examined and included: 1) triage begin to triage complete, 2) triage complete to ED bed placement, 3) ED bed placement to MD evaluation, 4) arrival to bed placement, and 5) arrival to departure (LOS). <br/><br/>Results/Outcomes: Project SMART resulted in patient satisfaction scores soaring from <br/>the 36th percentiles to the 95th percentile while the average patient LOS significantly decreased by almost one hour. The left-without-being-seen rate decreased from 2% to 0.13%. <br/><br/>In November 2008 (Phase 1), prior to the implementation of Project SMART, the ED's LOS averaged 204 minutes. A KPI LOS goal of 149 minutes was defined and in November 2009 the average LOS was decreased to 144 minutes. Phase 1 showed an initial arrival to bed placement of 52 minutes. A KPI of 14 minutes was predetermined and in November 2009 the average arrival to bed placement was reduced to 9 minutes. Phase 1 revealed that the triage process was 7-14 minutes. A KPI of 4 minutes was defined and in November 2009 the average triage process declined to 4 minutes. In Phase 1, the triage complete to ED bed placement averaged 30 minutes. A KPI of 4 minutes was defined and in November 2009 the average triage complete to bed placement was reduced to 2 minutes. The bed placement to MD evaluation averaged 41 minutes. A KPI of 8 minutes was defined and the time to bed placement to MD evaluation averaged 2 minutes, consequently contributing to meeting the goal of the &quot;30 minute promise&quot; to the community 95% of the time and decreasing the patient's overall LOS.<br/><br/>Implications: The implementation of best practices by decreasing patient wait time, <br/>reducing LOS, and promoting the &quot;30 minute promise&quot; has significantly increased patient satisfaction due to accelerated patient throughput.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:38Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:38Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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