2.50
Hdl Handle:
http://hdl.handle.net/10755/162471
Type:
Presentation
Title:
Rapid Assessment and Disposition
Abstract:
Rapid Assessment and Disposition
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Eller, Andrew, RN, BSN
P.I. Institution Name:St. Luke's Episcopal Hospital
Title:Clinical Educator
Contact Address:6720 Bertner Avenue, Spring, TX, 77030, USA
Contact Telephone:832-355-3147
[Clinical Poster] Clinical Topic: With emergency department overcrowding being a national issue, patient's length of stay rising, and hospital beds at capacity, we implemented a rapid assessment and disposition (RAD) process in our emergency department. The goal of this process was to improve overall length of stay and provide flexibility in utilizing department resources more appropriately.

Implementation: This collaborative effort involved emergency department physicians, management, department staff, and administration. The initial concept was developed after reviewing our current processes and identifying patient dissatisfiers and delays. We determined that to improve patient length of stay the physician needed more timely access to the patient. The process outline was developed and piloted based on the premise that all emergent patients should immediately be placed in a treatment room, and that all lower acuity patients do not require a treatment room. We developed a screening nurse role to greet and distribute patients as they present based on set criteria. An additional physician was scheduled for the RAD area with a nurse and patient care assistant. The RAD area was created from three existing treatment rooms; two remained treatment rooms, and one was converted into a holding area. After evaluating the patient and initiating appropriate orders, the physician would determine if the patient needed any further intervention requiring a treatment room. Patients not requiring a treatment room, but requiring further testing, would be placed in the RAD holding area.

Outcomes: In three months we have reduced the length of stay based on disposition for RAD patients on average by 52 minutes, from 237 minutes to 185 minutes. This represents a 22% decrease in length of stay for RAD patients. Currently 82% of RAD patients are discharged home. In the first three months we have averaged 254 patients through RAD representing 13,208 hours of time saved, and re-allocation of 254 rooms a month for higher acuity patients.

Recommendations: Being a large tertiary hospital in the fourth largest city in the nation, emergency department overcrowding is a concern. Our goal is to provide timely, quality care, to all patients presenting for emergent care. The RAD process will enable your department the flexibility to utilize resources differently to respond to the higher acute (ESI Level 1-2) patients while still caring for those who are less acute (ESI Level 3-5). RAD is more than your typical ôfast track,ö and assists in addressing current issues facing emergency departments today.
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.titleRapid Assessment and Dispositionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162471-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Rapid Assessment and Disposition</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">Eller, Andrew, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Luke's Episcopal Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Educator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6720 Bertner Avenue, Spring, TX, 77030, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">832-355-3147</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">aeller@sleh.com</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: With emergency department overcrowding being a national issue, patient's length of stay rising, and hospital beds at capacity, we implemented a rapid assessment and disposition (RAD) process in our emergency department. The goal of this process was to improve overall length of stay and provide flexibility in utilizing department resources more appropriately. <br/><br/>Implementation: This collaborative effort involved emergency department physicians, management, department staff, and administration. The initial concept was developed after reviewing our current processes and identifying patient dissatisfiers and delays. We determined that to improve patient length of stay the physician needed more timely access to the patient. The process outline was developed and piloted based on the premise that all emergent patients should immediately be placed in a treatment room, and that all lower acuity patients do not require a treatment room. We developed a screening nurse role to greet and distribute patients as they present based on set criteria. An additional physician was scheduled for the RAD area with a nurse and patient care assistant. The RAD area was created from three existing treatment rooms; two remained treatment rooms, and one was converted into a holding area. After evaluating the patient and initiating appropriate orders, the physician would determine if the patient needed any further intervention requiring a treatment room. Patients not requiring a treatment room, but requiring further testing, would be placed in the RAD holding area. <br/><br/>Outcomes: In three months we have reduced the length of stay based on disposition for RAD patients on average by 52 minutes, from 237 minutes to 185 minutes. This represents a 22% decrease in length of stay for RAD patients. Currently 82% of RAD patients are discharged home. In the first three months we have averaged 254 patients through RAD representing 13,208 hours of time saved, and re-allocation of 254 rooms a month for higher acuity patients. <br/><br/>Recommendations: Being a large tertiary hospital in the fourth largest city in the nation, emergency department overcrowding is a concern. Our goal is to provide timely, quality care, to all patients presenting for emergent care. The RAD process will enable your department the flexibility to utilize resources differently to respond to the higher acute (ESI Level 1-2) patients while still caring for those who are less acute (ESI Level 3-5). RAD is more than your typical &ocirc;fast track,&ouml; and assists in addressing current issues facing emergency departments today.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:46Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:46Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.