2.50
Hdl Handle:
http://hdl.handle.net/10755/162568
Type:
Presentation
Title:
Is Your ED in the "PITT"
Abstract:
Is Your ED in the "PITT"
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Jarvis, Susan, RN, MSN
P.I. Institution Name:Mission Hospital
Title: Administrative Director, Emergency Services
Contact Address:509 Biltmore Avenue, Asheville, NC, 28801, USA
Contact Telephone:828-213-1924
Co-Authors:Jason Hunt, MD; Sheila Radcliff, RN, BSN; Karen Blair, RN, BSN; Stephanie C. Whitaker, RN, BSN
Leadership Conference - Evidence-Based Practice Abstract: Is your ED in the ôPITTö?

Purpose: Waiting rooms were full, staff unhappy and patients dissatisfied. Door to doctor times soared to 92 minutes with door to bed time reaching 65 minutes. Patients were leaving without being seen at an alarming rate of 7.2%. The purpose of this project was to decrease door to doctor time by 50%, door to bed time by 50% and patients leaving without being seen to ? 2%.

Design: A quality improvement project was launched in June 2008.

Setting: This project took place in a not-for-profit, independent, community hospital system serving 17 counties in Western North Carolina. This Level II trauma center had >96,000 visits in 2008 and is known nationally for providing award-winning quality care.

Participants/Subjects: All patients presenting to the emergency department were included during select trial dates and times. A multi-disciplinary emergency department team developed and implemented the process.

Methods: Existing and emerging models of emergency department patient throughput were researched. Prototypes investigated included: physician or mid-level practitioner at triage, rapid bedding and team triage. After literature review and site visits, it was decided to trial a parallel process that included a rapid RN assessment, elimination of traditional triage and integration of the physician into a team triage concept (Physician Integrated Team Triage). Also, the traditional fast track was transformed into a faster-revolving Turbo Track. After development of the new patient flow algorithm with staff & physician participation, trials of the process began. Trial results were immediately evaluated; changes were suggested and implemented. Trials continued to expand until the process was fully implemented 7 days per week. Utilization of Focus PDCA performance improvement process resulted in a successful PITT implementation. The PITT process is now standard operating procedure. Success was measured by data collected, specifically: Door to doctor time, door to bed time, length of stay, percentage of patients leaving without being seen & patient satisfaction scores.

Results/Outcomes: Door to doctor & door to bed times were decreased by 50%. Percentage of patients leaving without being seen decreased from 7.1% to 2.0%. Length of stay decreased by 45 minutes. Patient satisfaction improved from the 13th percentile to the 69th percentile. During this process implementation ED volume increased by 8%.

Implications: Results indicate significant quality improvement can be accomplished with effective change management. This streamlined PITT process is reproducible in emergency departments across the nation regardless of size or scope. Getting out of the pits and into the PITT is possible!
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.titleIs Your ED in the "PITT"en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162568-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Is Your ED in the &quot;PITT&quot;</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">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Jarvis, Susan, RN, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mission Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value"> Administrative Director, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">509 Biltmore Avenue, Asheville, NC, 28801, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">828-213-1924</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">clnsxj@msj.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jason Hunt, MD; Sheila Radcliff, RN, BSN; Karen Blair, RN, BSN; Stephanie C. Whitaker, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: Is your ED in the &ocirc;PITT&ouml;?<br/><br/>Purpose: Waiting rooms were full, staff unhappy and patients dissatisfied. Door to doctor times soared to 92 minutes with door to bed time reaching 65 minutes. Patients were leaving without being seen at an alarming rate of 7.2%. The purpose of this project was to decrease door to doctor time by 50%, door to bed time by 50% and patients leaving without being seen to ? 2%. <br/><br/>Design: A quality improvement project was launched in June 2008. <br/><br/>Setting: This project took place in a not-for-profit, independent, community hospital system serving 17 counties in Western North Carolina. This Level II trauma center had &gt;96,000 visits in 2008 and is known nationally for providing award-winning quality care.<br/><br/>Participants/Subjects: All patients presenting to the emergency department were included during select trial dates and times. A multi-disciplinary emergency department team developed and implemented the process. <br/><br/>Methods: Existing and emerging models of emergency department patient throughput were researched. Prototypes investigated included: physician or mid-level practitioner at triage, rapid bedding and team triage. After literature review and site visits, it was decided to trial a parallel process that included a rapid RN assessment, elimination of traditional triage and integration of the physician into a team triage concept (Physician Integrated Team Triage). Also, the traditional fast track was transformed into a faster-revolving Turbo Track. After development of the new patient flow algorithm with staff &amp; physician participation, trials of the process began. Trial results were immediately evaluated; changes were suggested and implemented. Trials continued to expand until the process was fully implemented 7 days per week. Utilization of Focus PDCA performance improvement process resulted in a successful PITT implementation. The PITT process is now standard operating procedure. Success was measured by data collected, specifically: Door to doctor time, door to bed time, length of stay, percentage of patients leaving without being seen &amp; patient satisfaction scores.<br/><br/>Results/Outcomes: Door to doctor &amp; door to bed times were decreased by 50%. Percentage of patients leaving without being seen decreased from 7.1% to 2.0%. Length of stay decreased by 45 minutes. Patient satisfaction improved from the 13th percentile to the 69th percentile. During this process implementation ED volume increased by 8%.<br/><br/>Implications: Results indicate significant quality improvement can be accomplished with effective change management. This streamlined PITT process is reproducible in emergency departments across the nation regardless of size or scope. Getting out of the pits and into the PITT is possible! <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:23Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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