2.50
Hdl Handle:
http://hdl.handle.net/10755/162499
Type:
Presentation
Title:
Building the Clockwork Emergency Department - A Process Improvement Project
Abstract:
Building the Clockwork Emergency Department - A Process Improvement Project
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Johnson, Nicole, RN, MSN, MBA
P.I. Institution Name:Akron Children's Hospital
Title:Nurse Manager, Emergency Services
Contact Address:One Perkins Square, Akron, OH, 44308
Contact Telephone:330-543-8583
[Leadership Conference Poster Presentation] Purpose: Emergency department volumes have grown at a substantial rate over the past three years, with an annual average emergency department growth rate of 4.4% nationally. In the face of tremendous growth it is important to maintain a stable length of stay for all patients and maximize patient satisfaction. Ensuring that best practices are in place to handle the increased volume and focusing on patient throughput is imperative. Identifying and implementing proven best practices with the highest potential impact will improve the emergency departmentÆs ability to efficiently handle increasing demand.

Design: A performance improvement project was developed to focus on the efficiency of patient throughput in the emergency department. The project was a nine month engagement that consisted of weekly meetings, biweekly conference calls, and monthly executive updates. Four best practice solutions; rapid triage, bedside registration, preemptive test guidelines and instant bed status alerts, were identified and implemented. Quality measures, outcomes and performance were tracked and reported regularly.

Setting: The setting is an urban pediatric emergency department with level two trauma designation in the Midwest. The department sees about 65,000 patients a year.

Participants: The project consisted of four multidisciplinary teams directed by a team leader. Outside consultants served as external facilitators.

Methods: A project kick-off and staff workshop was held to launch the project and served to determine the objectives, educate on best practices and collect data to guide an opportunity assessment. The four best practice teams were launched and met regularly to create strategies and deliverables for implementation. The best practices were implemented in a staged approach with continuous data collection. A sustainability plan was created and initiated.

Results: One month after the implementation of rapid triage and beside registration, there was a 59% reduction in the arrival to room time interval and a 39% reduction in the arrival to physician exam time interval. This translates to a shorter wait for patients to see the physician, shorter average length of stay for the overall visit and increased patient satisfaction. Four months after the implementation of the instant bed status alerts, there was a decrease in total inpatient bed turnover time (the time from when a patient is discharged from on inpatient room to the time it is ready to receive another patient) by 22 minutes. Results from the implementation of the preemptive test guideline process have not yet been realized. There was an increase in teamwork and communication between the emergency department staff and its essential partners. A change in the culture of the department was noticeable and is expected to continue as the processes become embedded.

Recommendations: There is a need to continue with data collection and monitoring compliance. Sustainability of the process is crucial to maintaining its success through the emergency department's high volume season. Future efforts could include identifying additional best practices measures to address wait times in other intervals of the patient's emergency department visit such as time from physician exam to disposition.
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.titleBuilding the Clockwork Emergency Department - A Process Improvement Projecten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162499-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Building the Clockwork Emergency Department - A Process Improvement Project</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">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Johnson, Nicole, RN, MSN, MBA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Akron Children's Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Manager, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">One Perkins Square, Akron, OH, 44308</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">330-543-8583</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">njohnson@chmca.org</td></tr><tr><td colspan="2" class="item-abstract">[Leadership Conference Poster Presentation] Purpose: Emergency department volumes have grown at a substantial rate over the past three years, with an annual average emergency department growth rate of 4.4% nationally. In the face of tremendous growth it is important to maintain a stable length of stay for all patients and maximize patient satisfaction. Ensuring that best practices are in place to handle the increased volume and focusing on patient throughput is imperative. Identifying and implementing proven best practices with the highest potential impact will improve the emergency department&AElig;s ability to efficiently handle increasing demand.<br/><br/>Design: A performance improvement project was developed to focus on the efficiency of patient throughput in the emergency department. The project was a nine month engagement that consisted of weekly meetings, biweekly conference calls, and monthly executive updates. Four best practice solutions; rapid triage, bedside registration, preemptive test guidelines and instant bed status alerts, were identified and implemented. Quality measures, outcomes and performance were tracked and reported regularly.<br/><br/>Setting: The setting is an urban pediatric emergency department with level two trauma designation in the Midwest. The department sees about 65,000 patients a year. <br/><br/>Participants: The project consisted of four multidisciplinary teams directed by a team leader. Outside consultants served as external facilitators. <br/><br/>Methods: A project kick-off and staff workshop was held to launch the project and served to determine the objectives, educate on best practices and collect data to guide an opportunity assessment. The four best practice teams were launched and met regularly to create strategies and deliverables for implementation. The best practices were implemented in a staged approach with continuous data collection. A sustainability plan was created and initiated.<br/><br/>Results: One month after the implementation of rapid triage and beside registration, there was a 59% reduction in the arrival to room time interval and a 39% reduction in the arrival to physician exam time interval. This translates to a shorter wait for patients to see the physician, shorter average length of stay for the overall visit and increased patient satisfaction. Four months after the implementation of the instant bed status alerts, there was a decrease in total inpatient bed turnover time (the time from when a patient is discharged from on inpatient room to the time it is ready to receive another patient) by 22 minutes. Results from the implementation of the preemptive test guideline process have not yet been realized. There was an increase in teamwork and communication between the emergency department staff and its essential partners. A change in the culture of the department was noticeable and is expected to continue as the processes become embedded. <br/><br/>Recommendations: There is a need to continue with data collection and monitoring compliance. Sustainability of the process is crucial to maintaining its success through the emergency department's high volume season. Future efforts could include identifying additional best practices measures to address wait times in other intervals of the patient's emergency department visit such as time from physician exam to disposition.</td></tr></table>en_GB
dc.date.available2011-10-27T10:29:14Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:14Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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