2.50
Hdl Handle:
http://hdl.handle.net/10755/162493
Type:
Presentation
Title:
Solving ED Overcrowding: A Staff Initiated, System-Wide Approach
Abstract:
Solving ED Overcrowding: A Staff Initiated, System-Wide Approach
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Wagerman, Dawn, RN
P.I. Institution Name:Sinai Hospital
Title:RN
Contact Address:2401 W. Belvedere Avenue, Baltimore, MD, 21215, USA
Contact Telephone:410-601-5737
Co-Authors:Cynthia Krebs, RN, BSN, CEN; Diane Bongiovanni, MA, RN, CNAABC; and Verna T. Laidlow, RN, MS
[Clinical Poster] Clinical Topic: Emergency Department (ED) overcrowding is a daily problem in most ED's across America. The purpose of this project is to illustrate the effectiveness of an ED staff initiated multidisciplinary team that identifies organizational inefficiencies and recommends solutions across the continuum of care, combined with an initial medical screening by a midlevel provider instead of the traditional triage nurse. National ED benchmark indicators, along with improved patient care and increased patient satisfaction were used as metrics to demonstrate organizational success.

Implementation: At the outset of the program, the ED system was reconfigured so that a medical screening by a midlevel provider, instead of a triage nurse, occurred. Two committees were created to facilitate the project. The first committee consisted of ED staff and other members of the interdisciplinary team. The committee was responsible for identifying organizational barriers that hinder ED patient flow and for recommending solutions to the identified barriers. Solutions focused on coordination and collaboration with ancillary departments to facilitate completion of tests and ultimately patient disposition. The second committee consisted of executive leaders who were responsible for reviewing, approving, and financially supporting the recommendations. The ultimate goal of both committees was to ensure efficient care delivery across the patient care continuum.

Outcomes: The system-wide approach achieved astonishing results: door to provider time decreased from an average of 108 minutes to 65 minutes, door to discharge decreased from an average of 301 minutes to 237 minutes, door to admission time decreased from an average of 538 minutes to 413 minutes, left with out treatment (LWOT's) decreased from an average of 7% to 1.48%, EMS diversion hours decreased from 10.7 hours to 8.6 hours per day, and Press Ganey scores increased by 2.5%.

Recommendations: To improve quality of care in the ED, a system-wide evaluation of organizational inefficiencies is imperative. Developing a committee structure that involves the bedside nurse in developing solutions to problems can greatly impact national benchmark data. It is critical that organizational processes exist to support patient flow in the ED. The ED is the initial point of contact for many patients. The patient experience in the ED can have a tremendous impact on their view of the entire hospitalization. Achieving high results in the ED can result in high organizational performance.
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.titleSolving ED Overcrowding: A Staff Initiated, System-Wide Approachen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162493-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Solving ED Overcrowding: A Staff Initiated, System-Wide Approach</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">Wagerman, Dawn, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Sinai Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">RN</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2401 W. Belvedere Avenue, Baltimore, MD, 21215, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">410-601-5737</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dwagerma@lifebridgehealth.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Cynthia Krebs, RN, BSN, CEN; Diane Bongiovanni, MA, RN, CNAABC; and Verna T. Laidlow, RN, MS</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: Emergency Department (ED) overcrowding is a daily problem in most ED's across America. The purpose of this project is to illustrate the effectiveness of an ED staff initiated multidisciplinary team that identifies organizational inefficiencies and recommends solutions across the continuum of care, combined with an initial medical screening by a midlevel provider instead of the traditional triage nurse. National ED benchmark indicators, along with improved patient care and increased patient satisfaction were used as metrics to demonstrate organizational success.<br/><br/>Implementation: At the outset of the program, the ED system was reconfigured so that a medical screening by a midlevel provider, instead of a triage nurse, occurred. Two committees were created to facilitate the project. The first committee consisted of ED staff and other members of the interdisciplinary team. The committee was responsible for identifying organizational barriers that hinder ED patient flow and for recommending solutions to the identified barriers. Solutions focused on coordination and collaboration with ancillary departments to facilitate completion of tests and ultimately patient disposition. The second committee consisted of executive leaders who were responsible for reviewing, approving, and financially supporting the recommendations. The ultimate goal of both committees was to ensure efficient care delivery across the patient care continuum. <br/><br/>Outcomes: The system-wide approach achieved astonishing results: door to provider time decreased from an average of 108 minutes to 65 minutes, door to discharge decreased from an average of 301 minutes to 237 minutes, door to admission time decreased from an average of 538 minutes to 413 minutes, left with out treatment (LWOT's) decreased from an average of 7% to 1.48%, EMS diversion hours decreased from 10.7 hours to 8.6 hours per day, and Press Ganey scores increased by 2.5%.<br/><br/>Recommendations: To improve quality of care in the ED, a system-wide evaluation of organizational inefficiencies is imperative. Developing a committee structure that involves the bedside nurse in developing solutions to problems can greatly impact national benchmark data. It is critical that organizational processes exist to support patient flow in the ED. The ED is the initial point of contact for many patients. The patient experience in the ED can have a tremendous impact on their view of the entire hospitalization. Achieving high results in the ED can result in high organizational performance.</td></tr></table>en_GB
dc.date.available2011-10-27T10:29:08Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:08Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.