The Effectiveness of a Satelite Emergency Department which Provides Comprehensive, Safe Quality Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/162569
Type:
Presentation
Title:
The Effectiveness of a Satelite Emergency Department which Provides Comprehensive, Safe Quality Care
Abstract:
The Effectiveness of a Satelite Emergency Department which Provides Comprehensive, Safe Quality Care
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Kelly, Sharon, RN, MSN, NEA-BC
P.I. Institution Name:Overlook Hospital
Title:ED Director
Contact Address:99 Beauvoir Avenue, Summit, NJ, 07901, USA
Co-Authors:Lou Faraone, RN, CEN, NEMT-P
Leadership Conference - Evidence-Based Practice Abstract: The Effectiveness of a Satellite ED which provides Comprehensive, Safe Quality Care.


Purpose: The goal of opening a full service satellite was to provide safe quality and competent care to the community on a 24 hour basis, with a focus on a warm and caring environment. The satellite ED is committed to initiatives in improving patient satisfaction and decreasing the ED patientÆs overall length of stay. In addition, with local hospitals closing in the surrounding area, another goal was to decrease the overcrowding at the main hospital campus while delivering quality services without interrupted emergency care to the community.

Design: This quality improvement project was a collaborative effort between management, emergency department nursing leadership, physicians and educators.

Setting: The satellite ED is owned and operated by an acute care facility Level l teaching facility which provides emergency care to approximately 55,000 visits at the main campus and 25,000 visits at the satellite per year, as part of a 460 bed voluntary, not for profit, acute care hospital located in a suburban area. The satellite is located approximately 10 miles from the main hospital and has all the necessary personnel and equipment to run the equivalent of a hospital based ED, including radiology and lab services.

Subjects: The satellite can provide emergency services to any patient, adult and pediatric, transported by BLS and any other ambulatory arrivals. As per state regulations, although the satellite may provide care to all patients, cases more appropriately treated in an acute care setting include: patients requiring ALS and mobile intensive care services; altered mental status or pregnant women greater than 20 weeks.

Methods: State regulations and guidelines were adhered to and policies and procedures implemented. Other satellites in the state were benchmarked. ED processes and protocols from the main hospital were implemented, i.e. ESI 5 Level Triage, Code Stemi and Code Gray. An ED dashboard with metrics and goals was developed and implemented based on ED best practices. Monthly metrics include time to triage; time to physician; overall length of stay and patientÆs who left without being seen. Patient flow protocols are in place, including bedside registration. Communication and education to local EMS, BLS agencies and Fire Departments were initiated. Educational strategies include training of ED physician and nursing staff. Patient satisfaction initiatives which focus on open lines of communication, teamwork and best practices, including hourly rounding were also initiated.

Results: All ED dashboard metrics are consistently under goal times, including national goal times. Patients who left without being seen are well below the benchmark of 2%, consistently averaging below 0.5%. Median times to physician ranged for one year from 9 to 15 minutes per month, well below the goal of 30 minutes. Press Ganey scores have reached up to 99th percentile.

Implications: Providing a comprehensive, full service satellite with processes and ED best practices in place has proven to be lucrative and beneficial to both community and the main hospital. It has also demonstrated the commitment to providing high quality service to the community.

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.titleThe Effectiveness of a Satelite Emergency Department which Provides Comprehensive, Safe Quality Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162569-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effectiveness of a Satelite Emergency Department which Provides Comprehensive, Safe Quality Care</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">Kelly, Sharon, RN, MSN, NEA-BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Overlook Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">ED Director</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">99 Beauvoir Avenue, Summit, NJ, 07901, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Sharon.Kelly@atlantichealth.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Lou Faraone, RN, CEN, NEMT-P</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: The Effectiveness of a Satellite ED which provides Comprehensive, Safe Quality Care.<br/><br/><br/>Purpose: The goal of opening a full service satellite was to provide safe quality and competent care to the community on a 24 hour basis, with a focus on a warm and caring environment. The satellite ED is committed to initiatives in improving patient satisfaction and decreasing the ED patient&AElig;s overall length of stay. In addition, with local hospitals closing in the surrounding area, another goal was to decrease the overcrowding at the main hospital campus while delivering quality services without interrupted emergency care to the community.<br/><br/>Design: This quality improvement project was a collaborative effort between management, emergency department nursing leadership, physicians and educators.<br/><br/>Setting: The satellite ED is owned and operated by an acute care facility Level l teaching facility which provides emergency care to approximately 55,000 visits at the main campus and 25,000 visits at the satellite per year, as part of a 460 bed voluntary, not for profit, acute care hospital located in a suburban area. The satellite is located approximately 10 miles from the main hospital and has all the necessary personnel and equipment to run the equivalent of a hospital based ED, including radiology and lab services. <br/><br/>Subjects: The satellite can provide emergency services to any patient, adult and pediatric, transported by BLS and any other ambulatory arrivals. As per state regulations, although the satellite may provide care to all patients, cases more appropriately treated in an acute care setting include: patients requiring ALS and mobile intensive care services; altered mental status or pregnant women greater than 20 weeks. <br/><br/>Methods: State regulations and guidelines were adhered to and policies and procedures implemented. Other satellites in the state were benchmarked. ED processes and protocols from the main hospital were implemented, i.e. ESI 5 Level Triage, Code Stemi and Code Gray. An ED dashboard with metrics and goals was developed and implemented based on ED best practices. Monthly metrics include time to triage; time to physician; overall length of stay and patient&AElig;s who left without being seen. Patient flow protocols are in place, including bedside registration. Communication and education to local EMS, BLS agencies and Fire Departments were initiated. Educational strategies include training of ED physician and nursing staff. Patient satisfaction initiatives which focus on open lines of communication, teamwork and best practices, including hourly rounding were also initiated.<br/><br/>Results: All ED dashboard metrics are consistently under goal times, including national goal times. Patients who left without being seen are well below the benchmark of 2%, consistently averaging below 0.5%. Median times to physician ranged for one year from 9 to 15 minutes per month, well below the goal of 30 minutes. Press Ganey scores have reached up to 99th percentile.<br/><br/>Implications: Providing a comprehensive, full service satellite with processes and ED best practices in place has proven to be lucrative and beneficial to both community and the main hospital. It has also demonstrated the commitment to providing high quality service to the community.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:24Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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