2.50
Hdl Handle:
http://hdl.handle.net/10755/162467
Type:
Presentation
Title:
Triage Accuracy and Efficiency: Improving the Process in a Pediatric ED
Abstract:
Triage Accuracy and Efficiency: Improving the Process in a Pediatric ED
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Brecher, Deena, RN, MSN, CEN, APRN,BC
P.I. Institution Name:Nemours/A.I. duPont Hospital for Children
Title:Clinical Nurse Specialist
Contact Address:1600 Rockland Road, Wilmington, DE, 19803, USA
Contact Telephone:302-651-6282
[Clinical Poster] (Northeastern United States) Clinical Topic: Accurately sorting patients and quickly identifying potential life and limb threats is essential in any emergency department. The benchmark for a triage assessment is three to five minutes. Measuring the triage process presents unique challenges. Identifying meaningful data points is essential to collecting and evaluating data, and facilitating change.

Implementation: Efficiency measures were added to current accuracy measures in January 2006. Approximately 5% of each nurses' assessments are reviewed, first by a patient care facilitator, and the ED clinical nurse specialist (CNS) for acuity discrepancies. All of the discrepancies are discussed with the individual nurse.

Three opportunities for measurement of efficiency were identified; arrival time (AT), triage start (TS), and triage complete (TC). AT is captured electronically when the patient checks into the ED. Opening the triage form captures TS. TC is captured when the nurse signs their form. Each quarter, each individual RN's accuracy rate, AT to TC and TS to TC is calculated and compared to the departmental average.

Outcomes: The average TS to TC has decreased from 6.5 minutes in July 2006 to 4.04 minutes for the third quarter 2007. Awareness of their individual achievements provided an opportunity for suggestions to streamline the triage process. AT to TC times have dropped from 29 minutes in 1st quarter 2006 to a steady 16 minutes for the 2nd and 3rd quarter 2007. This measure allows the ED leadership team to identify how well an individual RN manages the front-end flow.

The accuracy rate increased from 86.5% to 89.8%, and has been steady for much of 2007. Each quarter, every RN with an accuracy rate greater than the departmental goal is identified as a "Triage Star" and entered in a quarterly drawing for a Target gift card.

Recommendations: Measuring only TS to TC does not give a complete picture of the efficiency of the triage process. TC should be measured at the time at which an acuity level is assigned. The additional measurement of AT to TC provides a more complete picture of the triage process. Individual feedback is essential to any process improvement strategy. Each RN should get a report of their progress on at least a quarterly basis, with feedback to identify personal goals, and celebration when those goals are met. Triage is an essential function of any ED. Attempts to improve the process should be driven with meaningful and measurable data.
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.titleTriage Accuracy and Efficiency: Improving the Process in a Pediatric EDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162467-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Triage Accuracy and Efficiency: Improving the Process in a Pediatric ED</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">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Brecher, Deena, RN, MSN, CEN, APRN,BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Nemours/A.I. duPont Hospital for Children</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1600 Rockland Road, Wilmington, DE, 19803, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">302-651-6282</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dbrecher@nemours.org</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] (Northeastern United States) Clinical Topic: Accurately sorting patients and quickly identifying potential life and limb threats is essential in any emergency department. The benchmark for a triage assessment is three to five minutes. Measuring the triage process presents unique challenges. Identifying meaningful data points is essential to collecting and evaluating data, and facilitating change.<br/><br/>Implementation: Efficiency measures were added to current accuracy measures in January 2006. Approximately 5% of each nurses' assessments are reviewed, first by a patient care facilitator, and the ED clinical nurse specialist (CNS) for acuity discrepancies. All of the discrepancies are discussed with the individual nurse. <br/><br/>Three opportunities for measurement of efficiency were identified; arrival time (AT), triage start (TS), and triage complete (TC). AT is captured electronically when the patient checks into the ED. Opening the triage form captures TS. TC is captured when the nurse signs their form. Each quarter, each individual RN's accuracy rate, AT to TC and TS to TC is calculated and compared to the departmental average.<br/><br/>Outcomes: The average TS to TC has decreased from 6.5 minutes in July 2006 to 4.04 minutes for the third quarter 2007. Awareness of their individual achievements provided an opportunity for suggestions to streamline the triage process. AT to TC times have dropped from 29 minutes in 1st quarter 2006 to a steady 16 minutes for the 2nd and 3rd quarter 2007. This measure allows the ED leadership team to identify how well an individual RN manages the front-end flow. <br/><br/>The accuracy rate increased from 86.5% to 89.8%, and has been steady for much of 2007. Each quarter, every RN with an accuracy rate greater than the departmental goal is identified as a &quot;Triage Star&quot; and entered in a quarterly drawing for a Target gift card. <br/><br/>Recommendations: Measuring only TS to TC does not give a complete picture of the efficiency of the triage process. TC should be measured at the time at which an acuity level is assigned. The additional measurement of AT to TC provides a more complete picture of the triage process. Individual feedback is essential to any process improvement strategy. Each RN should get a report of their progress on at least a quarterly basis, with feedback to identify personal goals, and celebration when those goals are met. Triage is an essential function of any ED. Attempts to improve the process should be driven with meaningful and measurable data.</td></tr></table>en_GB
dc.date.available2011-10-27T10:28:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:42Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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