2.50
Hdl Handle:
http://hdl.handle.net/10755/162436
Type:
Presentation
Title:
Improve ED Throughput with More Efficient Hand-offs
Abstract:
Improve ED Throughput with More Efficient Hand-offs
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Mikos, Kathy, RN, DNP
P.I. Institution Name:Ingalls Memorial Hospital
Title:Chief Nursing Officer
Contact Address:One Ingalls Drive, Harvey, IL, 60426, USA
Co-Authors:Paul Zielski, RN, ADN, BS, MBA
[ENA Leadership Conference] Evidence-based Practice Presentation: Improve ED Throughput with More Efficient Hand-offs

Purpose: The health system sought to improve patient throughput by increasing the efficiency of transfers through the emergency department. Bottlenecks in patient transfers caused long wait times, resulting in some patients leaving prior to treatment. The purpose of this project was to streamline ED throughput to improve patient experience and recover lost revenue for the hospital. The project involved process redesign followed by training and monitoring of staff adoption.

Design: This project was designed with the purpose of identifying evidence-based practice for improving ED patient throughput. The project involved defining an effective hand-off procedure to remove bottlenecks in patient transfers through the emergency department.

Setting: The project setting is a not-for-profit health system licensed for 563 beds. The system includes a network of outpatient centers that provide diagnostic and treatment services and urgent aid centers for 24/7 access to minor emergency care.

Participants/Subjects: Participants included staff members in the emergency department and nursing units. Team leaders were the Vice President of Patient Care Services, Director of Patient Care Services, Emergency Department Manager and Emergency Medical Director.

Methods: The hospital implemented technology to standardize, manage and monitor hand-offs. Hand-off reports are entered and received at any time through any phone, computer or mobile device. System prompts use the Situation-Background-Assessment-Recommendation format to standardize each report. An online component facilitates real-time monitoring, displaying status and completion for every hand-off. System flags show that reports have been entered and listened to and send alarms for unheard reports, prompting managers to establish contact for attention.

Results/Outcomes: Admit length of stay in the ED has fell from 420 minutes in the first quarter of 2008 to 315 minutes in the second quarter of 2010. During that same time period, the percentage of patients that left without being seen fell from 9.9 percent to 3.0 percent. ED visits increased by more than 3,900 patients, or over 9 percent, comparing fiscal year 2008 with projected fiscal year 2010. By treating more patients, the hospital's ED has added $5.5 million to net profit since the fiscal year ending September 30, 2008.

Implications: Incoming nurses can listen to standardized reports specific to their patients instead of the unit's entire census. This allows more time to ask questions and visit the patient bedside, all without causing overtime. Within the first month of implementing the process, the hospital saw a decrease in incremental overtime equal to two full-time employees each shift. The process also reduced wait time for treatment, with drops in the admission LOS and discharge LOS. By reducing the number of patients leaving without treatment, the hospital has improved patient care and avoided potential safety issues. Shortening transfer time has allowed patients to reach the care they need more quickly. In just over a year, patient satisfaction scores climbed from the 8th percentile to the 70th percentile by 1st quarter of 2010.
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.titleImprove ED Throughput with More Efficient Hand-offsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162436-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improve ED Throughput with More Efficient Hand-offs</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">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Mikos, Kathy, RN, DNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Ingalls Memorial Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Chief Nursing Officer</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">One Ingalls Drive, Harvey, IL, 60426, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kmikos@ingalls.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Paul Zielski, RN, ADN, BS, MBA</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Improve ED Throughput with More Efficient Hand-offs<br/><br/>Purpose: The health system sought to improve patient throughput by increasing the efficiency of transfers through the emergency department. Bottlenecks in patient transfers caused long wait times, resulting in some patients leaving prior to treatment. The purpose of this project was to streamline ED throughput to improve patient experience and recover lost revenue for the hospital. The project involved process redesign followed by training and monitoring of staff adoption.<br/><br/>Design: This project was designed with the purpose of identifying evidence-based practice for improving ED patient throughput. The project involved defining an effective hand-off procedure to remove bottlenecks in patient transfers through the emergency department.<br/><br/>Setting: The project setting is a not-for-profit health system licensed for 563 beds. The system includes a network of outpatient centers that provide diagnostic and treatment services and urgent aid centers for 24/7 access to minor emergency care.<br/><br/>Participants/Subjects: Participants included staff members in the emergency department and nursing units. Team leaders were the Vice President of Patient Care Services, Director of Patient Care Services, Emergency Department Manager and Emergency Medical Director.<br/><br/>Methods: The hospital implemented technology to standardize, manage and monitor hand-offs. Hand-off reports are entered and received at any time through any phone, computer or mobile device. System prompts use the Situation-Background-Assessment-Recommendation format to standardize each report. An online component facilitates real-time monitoring, displaying status and completion for every hand-off. System flags show that reports have been entered and listened to and send alarms for unheard reports, prompting managers to establish contact for attention.<br/><br/>Results/Outcomes: Admit length of stay in the ED has fell from 420 minutes in the first quarter of 2008 to 315 minutes in the second quarter of 2010. During that same time period, the percentage of patients that left without being seen fell from 9.9 percent to 3.0 percent. ED visits increased by more than 3,900 patients, or over 9 percent, comparing fiscal year 2008 with projected fiscal year 2010. By treating more patients, the hospital's ED has added $5.5 million to net profit since the fiscal year ending September 30, 2008.<br/><br/>Implications: Incoming nurses can listen to standardized reports specific to their patients instead of the unit's entire census. This allows more time to ask questions and visit the patient bedside, all without causing overtime. Within the first month of implementing the process, the hospital saw a decrease in incremental overtime equal to two full-time employees each shift. The process also reduced wait time for treatment, with drops in the admission LOS and discharge LOS. By reducing the number of patients leaving without treatment, the hospital has improved patient care and avoided potential safety issues. Shortening transfer time has allowed patients to reach the care they need more quickly. In just over a year, patient satisfaction scores climbed from the 8th percentile to the 70th percentile by 1st quarter of 2010.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:11Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:11Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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