2.50
Hdl Handle:
http://hdl.handle.net/10755/162537
Type:
Presentation
Title:
Staff Driven Initiatives for Improving Patient Flow
Abstract:
Staff Driven Initiatives for Improving Patient Flow
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:North-Giles, Shannon M., RN, BS, CEN
P.I. Institution Name:Inova Springfield Healthplex
Title:Clinical Leader, RN 4
Contact Address:6355 Walker Lane, Alexandria, VA, USA
Contact Telephone:703-797-6850
Co-Authors:Susan Naito Dungan, RN, BA
[Annual Conference] Clinical Topic: Efficient patient flow through an Emergency Department is an essential component in many aspects of Emergency Care. Increasing lengths of stay lend themselves to multiple concerns regarding quality care, patient safety, patient and staff satisfaction, and unnecessary overcrowding. Many Emergency Departments are experiencing increasing length of stay due to increasing patient volume and are still using outdated models of throughput. Developing a facility-specific plan focusing on effective patient flow through an Emergency Department can resolve many these concerns.

Implementation: This Free Standing Emergency Department established a shared governing committee to identify specific opportunities for process improvements to decrease length of stay. Based on the findings and staff identified needs, a schematic plan was initiated with a high priority focusing on:

1) Decreasing Door to Triage: All staff was educated on the ESI 5 tier triage, and the first point of entry for the patient became an RN. This ensured safety in our ED during surge capacity.
2) Increasing use of Advance Triage Protocols: Efficiencies gained by an RN as the first point of entry were seen in the increase use of diagnostic testing right away using standard protocols. Shifting of manpower to the front allowed for advanced protocols to be carried out allowing patients the benefit of lab and radiology testing while waiting for their medical screen.
3) Decreasing Door to Doctor: Team patient care was standardized in the unit promoting accountability to a specific zone of patients. Efficiencies gained were seen in a decrease in wait time from door to Doctor.

Outcomes: Time to triage: decreased from 20 minutes to 6 minutes (timeframe July-December 2008)

1) Use of advanced triage protocols: baseline prior to evaluation 10%, increasing to 80% at end of project.
2) Time to doctor: decreased from an average of 85 minutes to an average of 32 minutes (timeframe June-December 2008)
3) Length of Stay in ED: decreased from 180 minutes to 140 minutes (timeframe January 2008-December 2008) with ultimate benchmark of 120 minutes.

Recommendations: Decreasing Length of Stay in an Emergency Department is a direct indicator of Quality of care. By focusing on 3 indicators for decreased length of stay, process improvement can be made. However, the success of this project was because an environment of culture change was implemented by staff themselves and supported by Senior Leadership. Change for improvement needs to start from the bottom up in order for change to be standardized and hardwired. The success of this project has now created a work environment that is open to change and improvement.
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.titleStaff Driven Initiatives for Improving Patient Flowen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162537-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Staff Driven Initiatives for Improving Patient Flow</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">North-Giles, Shannon M., RN, BS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Inova Springfield Healthplex</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Leader, RN 4</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6355 Walker Lane, Alexandria, VA, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">703-797-6850</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">shannon.north-giles@inova.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Susan Naito Dungan, RN, BA</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Efficient patient flow through an Emergency Department is an essential component in many aspects of Emergency Care. Increasing lengths of stay lend themselves to multiple concerns regarding quality care, patient safety, patient and staff satisfaction, and unnecessary overcrowding. Many Emergency Departments are experiencing increasing length of stay due to increasing patient volume and are still using outdated models of throughput. Developing a facility-specific plan focusing on effective patient flow through an Emergency Department can resolve many these concerns. <br/><br/>Implementation: This Free Standing Emergency Department established a shared governing committee to identify specific opportunities for process improvements to decrease length of stay. Based on the findings and staff identified needs, a schematic plan was initiated with a high priority focusing on:<br/><br/>1) Decreasing Door to Triage: All staff was educated on the ESI 5 tier triage, and the first point of entry for the patient became an RN. This ensured safety in our ED during surge capacity. <br/>2) Increasing use of Advance Triage Protocols: Efficiencies gained by an RN as the first point of entry were seen in the increase use of diagnostic testing right away using standard protocols. Shifting of manpower to the front allowed for advanced protocols to be carried out allowing patients the benefit of lab and radiology testing while waiting for their medical screen. <br/>3) Decreasing Door to Doctor: Team patient care was standardized in the unit promoting accountability to a specific zone of patients. Efficiencies gained were seen in a decrease in wait time from door to Doctor.<br/> <br/> Outcomes: Time to triage: decreased from 20 minutes to 6 minutes (timeframe July-December 2008)<br/><br/>1) Use of advanced triage protocols: baseline prior to evaluation 10%, increasing to 80% at end of project.<br/>2) Time to doctor: decreased from an average of 85 minutes to an average of 32 minutes (timeframe June-December 2008)<br/>3) Length of Stay in ED: decreased from 180 minutes to 140 minutes (timeframe January 2008-December 2008) with ultimate benchmark of 120 minutes.<br/> <br/>Recommendations: Decreasing Length of Stay in an Emergency Department is a direct indicator of Quality of care. By focusing on 3 indicators for decreased length of stay, process improvement can be made. However, the success of this project was because an environment of culture change was implemented by staff themselves and supported by Senior Leadership. Change for improvement needs to start from the bottom up in order for change to be standardized and hardwired. The success of this project has now created a work environment that is open to change and improvement.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:52Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:52Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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