2.50
Hdl Handle:
http://hdl.handle.net/10755/162508
Type:
Presentation
Title:
Innovative Emergency Triage Rapid Medical Triage (RMET)
Abstract:
Innovative Emergency Triage Rapid Medical Triage (RMET)
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Bernatene, Kelly, RN,BSN
P.I. Institution Name:Arrowhead Regional Medical Center
Title:ED Nurse Manager
Contact Address:400 North Pepper Ave., Colton, CA, 92324, USA
Contact Telephone:909-580-1415
Co-Authors:Sonny Alforja, RN, BSN; Rodney Borger, D.O.; Jonathan Lee, RN, BSN; Richard Hausman, D.O.
[Annual Conference] Clinical Topic: The increasing patient visits to emergency departments throughout the nation have stressed the current system of triaging and treating patients. As a result, hospitals have to adapt by implementing a more efficient and streamlined change in our triage and treatment process.

Implementation: Patient data was collected post visit through a chart review of each medical record. The patient's time from emergency department check-in to examination by a medical provider and number of patient's left without being seen by a provider was the two of the main indicators to determining success of the new process.
Treatment process change consisted of the implementation of new front triage area, triage system process and provider roles. The triage design consists of a Intake RN station, registration area and 6 cubicle triage and medical evaluation area.
Patients present to an experienced ED nurse who establishes if the patient's acuity meets criteria for immediate bedding or appropriate for the triage process. The patient then is registered, chart created and a formal triage is completed by a triage nurse. The patient is then seen by medical providers dedicated to the medical screening of these patients only. This point is where the decision for discharge or further work-up is made.
If the patient is to receive further testing or imaging then the chart is assigned to a resource area. Completion of orders are performed and follow up in the resource area, and it is the responsibility of the medical provider assigned to this area. This allows the medical providers to continue to examine and evaluate patients as they arrive to the emergency room instead of following each patient until discharge.

Outcomes: Implementation of this new triage process occurred March of 2009. The data collected covers February 2008 to December 2009.
The results of the study show a dramatic decrease in wait times for patients who present to the emergency room. The average "door to doctor time" for February 2008 to February 2009 was 56.25 minutes with average patient flow of 9526 monthly visits. The average door to doctor time since implementation of the new process is 30.5 minutes with an average patient flow of 10913 monthly visits.
Patient's who leave without being seen by a medical provider also showed a dramatic decrease. Left without being seen (LWBS) was tracked and the average number of patients was 270 monthly for February 2008 to February 2009. After implementation the average decreased to 99 patients monthly.

Recommendations: Redesigning the patient flow through the triage process resulted in more efficient medical care of patients presenting to the emergency department. With assigned roles in the new triage process, nurses and medical providers can efficiently see and treat patients.
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.titleInnovative Emergency Triage Rapid Medical Triage (RMET)en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162508-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Innovative Emergency Triage Rapid Medical Triage (RMET)</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">Bernatene, Kelly, RN,BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Arrowhead Regional Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">ED Nurse Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">400 North Pepper Ave., Colton, CA, 92324, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">909-580-1415</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bernatenek@armc.sbcounty.gov</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sonny Alforja, RN, BSN; Rodney Borger, D.O.; Jonathan Lee, RN, BSN; Richard Hausman, D.O.</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: The increasing patient visits to emergency departments throughout the nation have stressed the current system of triaging and treating patients. As a result, hospitals have to adapt by implementing a more efficient and streamlined change in our triage and treatment process. <br/><br/>Implementation: Patient data was collected post visit through a chart review of each medical record. The patient's time from emergency department check-in to examination by a medical provider and number of patient's left without being seen by a provider was the two of the main indicators to determining success of the new process. <br/> Treatment process change consisted of the implementation of new front triage area, triage system process and provider roles. The triage design consists of a Intake RN station, registration area and 6 cubicle triage and medical evaluation area. <br/> Patients present to an experienced ED nurse who establishes if the patient's acuity meets criteria for immediate bedding or appropriate for the triage process. The patient then is registered, chart created and a formal triage is completed by a triage nurse. The patient is then seen by medical providers dedicated to the medical screening of these patients only. This point is where the decision for discharge or further work-up is made. <br/>If the patient is to receive further testing or imaging then the chart is assigned to a resource area. Completion of orders are performed and follow up in the resource area, and it is the responsibility of the medical provider assigned to this area. This allows the medical providers to continue to examine and evaluate patients as they arrive to the emergency room instead of following each patient until discharge. <br/><br/>Outcomes: Implementation of this new triage process occurred March of 2009. The data collected covers February 2008 to December 2009. <br/> The results of the study show a dramatic decrease in wait times for patients who present to the emergency room. The average &quot;door to doctor time&quot; for February 2008 to February 2009 was 56.25 minutes with average patient flow of 9526 monthly visits. The average door to doctor time since implementation of the new process is 30.5 minutes with an average patient flow of 10913 monthly visits. <br/> Patient's who leave without being seen by a medical provider also showed a dramatic decrease. Left without being seen (LWBS) was tracked and the average number of patients was 270 monthly for February 2008 to February 2009. After implementation the average decreased to 99 patients monthly. <br/><br/>Recommendations: Redesigning the patient flow through the triage process resulted in more efficient medical care of patients presenting to the emergency department. With assigned roles in the new triage process, nurses and medical providers can efficiently see and treat patients. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:23Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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