2.50
Hdl Handle:
http://hdl.handle.net/10755/162652
Type:
Presentation
Title:
Emergency Department Overcrowding: Urgent Solution - Urgent Care
Abstract:
Emergency Department Overcrowding: Urgent Solution - Urgent Care
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Dilts Skaggs, Mary Kate, RN, MSN, CNA
P.I. Institution Name:Southern Ohio Medical Center
Title:Director of Nursing : Emergency & Outpatient Services
Contact Address:1805 27th Street, Portsmouth, OH, 45662, USA
Contact Telephone:(740) 356-8430
Co-Authors:Sherry L. Foster, RN
[Clinical Poster] Clinical Topic: Emergency department (ED) overcrowding has become commonplace in hospitals nationwide. In 1997, continual ED overcrowding at this emergency department with 61,793 annual ED visits led hospital administration to make the decision to open an urgent care center (UCC) to decrease lower-acuity ED visits that could be appropriately treated in a UCC setting. The urgent care center is located approximately 10 miles from the main emergency department. The first year that the urgent care center was opened, 15,735 patients were seen and the ED patient volume declined to 56,091 visits. However, over time, annual visits at both facilities have continued to increase. By 2004, patient satisfaction scores at the urgent care center were at an all-time low. The focus of this project was to improve UCC patient satisfaction and decrease their throughput time.

Implementation: The urgent care center is part of a 200-bed, rural, non-profit, teaching hospital in Southern Ohio. A multidisciplinary team (consisting of the medical director, nurse manager, licensed practical nurse, urgent care technician, medical imaging technologist, and registrar) used a FOCUS-PDCA (Plan-Do-Check-Act) process improvement model. FOCUS stands for: Find a Process to improve; Organize the team to improve the process; Clarify the current knowledge of the process; Understand the sources of process variation; and Select a process improvement. The team meets monthly to discuss operational issues. Rapid cycle testing, a method for process improvement, was implemented. This method utilizes just-in-time training for staff currently on duty to trial a new process. The process change in question can be turned "on" for several hours and then "off" so that results may be quickly evaluated before a final process change is implemented. A blended work space for nursing and registration that allowed privacy for the patient as well as patient flow processes during triage and registration was constructed. A call-back program was established to allow UCC Staff to phone patients 2-3 days post-visit to check on their status. Most calls are made between 10 AM - 6 PM (Monday-Friday). The scope of services includes treating UCC patients, outpatient laboratory, and medical imaging studies. The UCC staff is comprised of a nurse manager, a registered nurse, five licensed practical nurses, four medical imaging technologists, two urgent care technicians, eight registrars, and one housekeeper.

Outcomes: Press Ganey satisfaction surveys are sent on an ongoing basis to UCC patients. Patient and employee satisfaction scores along with their response rates were continually monitored. In October 2004, UCC overall patient satisfaction, satisfaction with nurses, and satisfaction with physicians were at the 38th, 53rd, and 40th percentiles, respectively. As of March 2007, the urgent care center has experienced a substantial increase in overall patient satisfaction, satisfaction with nurses, and satisfaction with physicians to the 84th, 76th, and 73rd percentiles. Verbal feedback from patients has been great. UCC employee satisfaction is at the 98th percentile (October 2006) compared to the 89th percentile (April 2005). The call-back program allows the nurse manager insight into patient feedback on any issue that they may have experienced, positive or negative, during their visit. Additionally, UCC throughput time was decreased to 60-70 minutes compared to 2.7 hours (ED throughput time).

Recommendations: The multidisciplinary approach allowed staff to be involved in revising processes to improve patient flow. Instituting a call-back program conveys caring to your patients and their families. The overall changes have resulted in both an increase in patient and staff satisfaction. The urgent care center is a viable alternative for some patients improving emergency and urgent care in 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.titleEmergency Department Overcrowding: Urgent Solution - Urgent Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162652-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Department Overcrowding: Urgent Solution - Urgent 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">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dilts Skaggs, Mary Kate, RN, MSN, CNA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Southern Ohio Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director of Nursing : Emergency &amp; Outpatient Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1805 27th Street, Portsmouth, OH, 45662, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(740) 356-8430</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">skaggsmk@somc.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sherry L. Foster, RN</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: Emergency department (ED) overcrowding has become commonplace in hospitals nationwide. In 1997, continual ED overcrowding at this emergency department with 61,793 annual ED visits led hospital administration to make the decision to open an urgent care center (UCC) to decrease lower-acuity ED visits that could be appropriately treated in a UCC setting. The urgent care center is located approximately 10 miles from the main emergency department. The first year that the urgent care center was opened, 15,735 patients were seen and the ED patient volume declined to 56,091 visits. However, over time, annual visits at both facilities have continued to increase. By 2004, patient satisfaction scores at the urgent care center were at an all-time low. The focus of this project was to improve UCC patient satisfaction and decrease their throughput time.<br/><br/>Implementation: The urgent care center is part of a 200-bed, rural, non-profit, teaching hospital in Southern Ohio. A multidisciplinary team (consisting of the medical director, nurse manager, licensed practical nurse, urgent care technician, medical imaging technologist, and registrar) used a FOCUS-PDCA (Plan-Do-Check-Act) process improvement model. FOCUS stands for: Find a Process to improve; Organize the team to improve the process; Clarify the current knowledge of the process; Understand the sources of process variation; and Select a process improvement. The team meets monthly to discuss operational issues. Rapid cycle testing, a method for process improvement, was implemented. This method utilizes just-in-time training for staff currently on duty to trial a new process. The process change in question can be turned &quot;on&quot; for several hours and then &quot;off&quot; so that results may be quickly evaluated before a final process change is implemented. A blended work space for nursing and registration that allowed privacy for the patient as well as patient flow processes during triage and registration was constructed. A call-back program was established to allow UCC Staff to phone patients 2-3 days post-visit to check on their status. Most calls are made between 10 AM - 6 PM (Monday-Friday). The scope of services includes treating UCC patients, outpatient laboratory, and medical imaging studies. The UCC staff is comprised of a nurse manager, a registered nurse, five licensed practical nurses, four medical imaging technologists, two urgent care technicians, eight registrars, and one housekeeper.<br/><br/>Outcomes: Press Ganey satisfaction surveys are sent on an ongoing basis to UCC patients. Patient and employee satisfaction scores along with their response rates were continually monitored. In October 2004, UCC overall patient satisfaction, satisfaction with nurses, and satisfaction with physicians were at the 38th, 53rd, and 40th percentiles, respectively. As of March 2007, the urgent care center has experienced a substantial increase in overall patient satisfaction, satisfaction with nurses, and satisfaction with physicians to the 84th, 76th, and 73rd percentiles. Verbal feedback from patients has been great. UCC employee satisfaction is at the 98th percentile (October 2006) compared to the 89th percentile (April 2005). The call-back program allows the nurse manager insight into patient feedback on any issue that they may have experienced, positive or negative, during their visit. Additionally, UCC throughput time was decreased to 60-70 minutes compared to 2.7 hours (ED throughput time).<br/><br/>Recommendations: The multidisciplinary approach allowed staff to be involved in revising processes to improve patient flow. Instituting a call-back program conveys caring to your patients and their families. The overall changes have resulted in both an increase in patient and staff satisfaction. The urgent care center is a viable alternative for some patients improving emergency and urgent care in the community.</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:50Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.