2.50
Hdl Handle:
http://hdl.handle.net/10755/162449
Type:
Presentation
Title:
Treasure Hunt: Searching for Inpatient Beds
Abstract:
Treasure Hunt: Searching for Inpatient Beds
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Wagner, Jennifer, RN, BSN
P.I. Institution Name:Baylor University Medical Center
Title:Staff Nurse
Contact Address:2707 Cole Avenue #408, Dallas, TX, 75204, USA
Contact Telephone:214-820-2694
Co-Authors:Jim Sullivan, RN, BSN, CEN
[ENA Leadership Conference] Evidence-based Practice Presentation: Treasure Hunt: Searching for Inpatient Beds

Purpose: The objective of this project was to automate throughput to increase patient flow from the ED to the inpatient setting while adhering to patient-centered principles. Time increases in admit holds, up to 24 hours, warranted the maximization of patient flow from the ED to Inpatient status.

Design: This quality assurance project involved an evaluation of throughput issues, alternatives for consideration, and recommendations for improvement based on a cost/benefit analysis using the Deming Cycle. A steering committee was developed which examined patient flow from the ED and implemented a work flow change within the facility. With this analysis, the facility organized and developed a new patient flow process to expedite throughput from the ED to Inpatient units. Senior Leadership recognized the problem and cascaded the solution down to the appropriate directors/personnel.

Setting: The project was implemented in an inner city Level 1 Trauma Center (a tertiary referral center) with 88 ED beds and 1000 licensed inpatient beds.

Participants/Subjects: A multidisciplinary team was developed consisting of senior leadership, directors, and nurse managers. Also included on the team were ED and inpatient nurses, ancillary staff, and vendor representatives for support and guidance throughout the decision making process.

Methods: Current and future state analyses utilized flowcharts of current and future processes and resulted in the selection of an electronic bed board and patient flow metrics. The metrics selected included ED visits, daily LOS, and lost revenue. The measurement of admit holds is hours held divided by the number of admits per month. Admit holds are defined as emergency care complete until arrival on the inpatient unit.

Results: By compiling pre and post data gathered in February and March 2010, implementation of the tracking system in April 2010, and by analyzing significant data compiled from May and June 2010. This data showed current patient flow from the ED to inpatient beds and led to the redesign of patient flow processes, and a culture change to ôpull until fullö on all inpatient units. Daily admit hold hours decreased from 265 to 109. An additional lesson learned is while transparency is good, it can be uncomfortable if you have never been transparent.

Implications: The use of current and future state analyses is an effective method for redesigning important process issues. By adding a bed board and metrics, we were able to significantly increase throughput from the ED to Inpatient settings. The changes were implemented by educating the staff utilizing group (PowerPoint) presentations, one on one education, classes that were conducted for practice of the new system, and email. There were super trainers available for support on all units during and post implementation of the new system. The super trainer was available to answer questions for front end users for one week post go live for all hospital staff. This produced buy in from staff at all levels of the organization.
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.titleTreasure Hunt: Searching for Inpatient Bedsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162449-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Treasure Hunt: Searching for Inpatient Beds</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">Wagner, Jennifer, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Baylor University Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Staff Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2707 Cole Avenue #408, Dallas, TX, 75204, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">214-820-2694</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jennifer.wagner@baylorhealth.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jim Sullivan, RN, BSN, CEN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Treasure Hunt: Searching for Inpatient Beds<br/><br/>Purpose: The objective of this project was to automate throughput to increase patient flow from the ED to the inpatient setting while adhering to patient-centered principles. Time increases in admit holds, up to 24 hours, warranted the maximization of patient flow from the ED to Inpatient status. <br/><br/>Design: This quality assurance project involved an evaluation of throughput issues, alternatives for consideration, and recommendations for improvement based on a cost/benefit analysis using the Deming Cycle. A steering committee was developed which examined patient flow from the ED and implemented a work flow change within the facility. With this analysis, the facility organized and developed a new patient flow process to expedite throughput from the ED to Inpatient units. Senior Leadership recognized the problem and cascaded the solution down to the appropriate directors/personnel. <br/><br/>Setting: The project was implemented in an inner city Level 1 Trauma Center (a tertiary referral center) with 88 ED beds and 1000 licensed inpatient beds. <br/><br/>Participants/Subjects: A multidisciplinary team was developed consisting of senior leadership, directors, and nurse managers. Also included on the team were ED and inpatient nurses, ancillary staff, and vendor representatives for support and guidance throughout the decision making process. <br/><br/>Methods: Current and future state analyses utilized flowcharts of current and future processes and resulted in the selection of an electronic bed board and patient flow metrics. The metrics selected included ED visits, daily LOS, and lost revenue. The measurement of admit holds is hours held divided by the number of admits per month. Admit holds are defined as emergency care complete until arrival on the inpatient unit. <br/><br/>Results: By compiling pre and post data gathered in February and March 2010, implementation of the tracking system in April 2010, and by analyzing significant data compiled from May and June 2010. This data showed current patient flow from the ED to inpatient beds and led to the redesign of patient flow processes, and a culture change to &ocirc;pull until full&ouml; on all inpatient units. Daily admit hold hours decreased from 265 to 109. An additional lesson learned is while transparency is good, it can be uncomfortable if you have never been transparent. <br/><br/>Implications: The use of current and future state analyses is an effective method for redesigning important process issues. By adding a bed board and metrics, we were able to significantly increase throughput from the ED to Inpatient settings. The changes were implemented by educating the staff utilizing group (PowerPoint) presentations, one on one education, classes that were conducted for practice of the new system, and email. There were super trainers available for support on all units during and post implementation of the new system. The super trainer was available to answer questions for front end users for one week post go live for all hospital staff. This produced buy in from staff at all levels of the organization.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:24Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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