2.50
Hdl Handle:
http://hdl.handle.net/10755/162438
Type:
Presentation
Title:
Reducing Wait Times and Left Without Being Seen Rates
Abstract:
Reducing Wait Times and Left Without Being Seen Rates
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Phillips, Jodiann, RN, BSN, CEN
P.I. Institution Name:Baylor Medical Center at Waxahachie
Title:Nurse Manager, Emergency Department
Contact Address:1405 West Jefferson Street, Waxahachie, TX, 75165, USA
Contact Telephone:972-923-7105
[ENA Leadership Conference] Evidence-based Practice Presentation: Reducing Wait Times and Left Without Being Seen Rates

Purpose: American emergency departments have experienced unprecedented growth in patient volumes over the last decade. There has been an increase in emergency patient visits while the number of operating emergency departments has decreased. The United States Government Accountability Office listed a 2006 average wait time to be seen by an ED medical provider as 37 minutes. Overall U.S. hospital ED level performance is poor in timeliness to treatment of acutely ill patients and in the ability to keep ED length of stay within four or six hours. The purpose of this project was to reduce ED wait times by improving arrival to bed and bed to medical provider times and reduce left without being seen rates.

Design: Process improvement project teams used the Plan, Do, Check, Act methodology over a two year period to define processes, implement interventions and evaluate outcomes.

Setting: The setting is a 24-bed emergency department in a 55-bed not-for-profit community hospital in North Texas. The emergency department consists of 15 main ED beds and nine minor emergency clinic beds and is not trauma designated. The department employs 45 Registered Nurses, 10 ED Technicians and five secretaries. It is staffed with one ED physician, two midlevel providers in the main ED and one midlevel in the emergency clinic.

Participants/Subjects: The subjects are all adult and pediatric patients registered into the emergency department. The annual census in fiscal year 2010 was 42,715.

Methods: Interventions to improve efficiency included accelerated triage, immediate placement in available beds (closed waiting room), assignment of a Registered Nurse as a patient flow coordinator to focus on arriving patients, addition of a nine bed emergency clinic for fast tracking ESI Level 4 and 5 patients, setting targets for arrival to bed and bed to physician, hourly rounding by staff nurses, charge nurses-physician huddles and charge nurse rounding. Data were extracted from the ED patient tracking system retrospectively and measured weekly and then monthly. Measurement times included arrival to bed, bed to medical provider, arrival to medical provider and left without being seen totals and percentage of total volume.

Results/Outcomes: The interventions resulted in marked improvements in ED metrics in fiscal year 2010 over fiscal year 2009. Mean arrival to bed times decreased 18%. Mean bed to medical provider decreased 27%. Mean arrival to medical provider decreased 23% and total numbers of patients who left without being seen decreased 23%.

Implications: By improving emergency department internal efficiencies and reducing wait times, left without being seen rates can improve.
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.titleReducing Wait Times and Left Without Being Seen Ratesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162438-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Reducing Wait Times and Left Without Being Seen Rates</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">Phillips, Jodiann, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Baylor Medical Center at Waxahachie</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Manager, Emergency Department</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1405 West Jefferson Street, Waxahachie, TX, 75165, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">972-923-7105</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jodiprn@yahoo.com</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Reducing Wait Times and Left Without Being Seen Rates<br/><br/>Purpose: American emergency departments have experienced unprecedented growth in patient volumes over the last decade. There has been an increase in emergency patient visits while the number of operating emergency departments has decreased. The United States Government Accountability Office listed a 2006 average wait time to be seen by an ED medical provider as 37 minutes. Overall U.S. hospital ED level performance is poor in timeliness to treatment of acutely ill patients and in the ability to keep ED length of stay within four or six hours. The purpose of this project was to reduce ED wait times by improving arrival to bed and bed to medical provider times and reduce left without being seen rates.<br/><br/>Design: Process improvement project teams used the Plan, Do, Check, Act methodology over a two year period to define processes, implement interventions and evaluate outcomes.<br/><br/>Setting: The setting is a 24-bed emergency department in a 55-bed not-for-profit community hospital in North Texas. The emergency department consists of 15 main ED beds and nine minor emergency clinic beds and is not trauma designated. The department employs 45 Registered Nurses, 10 ED Technicians and five secretaries. It is staffed with one ED physician, two midlevel providers in the main ED and one midlevel in the emergency clinic.<br/><br/>Participants/Subjects: The subjects are all adult and pediatric patients registered into the emergency department. The annual census in fiscal year 2010 was 42,715. <br/><br/>Methods: Interventions to improve efficiency included accelerated triage, immediate placement in available beds (closed waiting room), assignment of a Registered Nurse as a patient flow coordinator to focus on arriving patients, addition of a nine bed emergency clinic for fast tracking ESI Level 4 and 5 patients, setting targets for arrival to bed and bed to physician, hourly rounding by staff nurses, charge nurses-physician huddles and charge nurse rounding. Data were extracted from the ED patient tracking system retrospectively and measured weekly and then monthly. Measurement times included arrival to bed, bed to medical provider, arrival to medical provider and left without being seen totals and percentage of total volume.<br/><br/>Results/Outcomes: The interventions resulted in marked improvements in ED metrics in fiscal year 2010 over fiscal year 2009. Mean arrival to bed times decreased 18%. Mean bed to medical provider decreased 27%. Mean arrival to medical provider decreased 23% and total numbers of patients who left without being seen decreased 23%.<br/><br/>Implications: By improving emergency department internal efficiencies and reducing wait times, left without being seen rates can improve.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:13Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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