2.50
Hdl Handle:
http://hdl.handle.net/10755/162696
Type:
Presentation
Title:
The Reality of Immediate Bedding; Journey Through the Looking Glass
Abstract:
The Reality of Immediate Bedding; Journey Through the Looking Glass
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Godfrey, Marcus, RN
P.I. Institution Name:Sutter Roseville Medical Center
Title:Clinical Nurse Manager, Emergency Department
Contact Address:1 Medical Plaza, Roseville, CA, 95661-3037, USA
Contact Telephone:(916) 781-1366
Purpose: Immediate bedding can be the answer to decreasing arrival to physician times, Left Without Being Seen (LWBS), ambulance diversion; and a sound business plan for volume growth to increase market share in a competitive healthcare market. Arrival to physician time standards are decreasing and the concept of triage nurse as the sole gate keeper of the department is antiquated.

Design: This is a process improvement project involving the ED Physicians and Charge Nurses. They were given the task to find a solution to immediate bedding.

Setting: This is a suburban level II trauma center/ level II emergency department with 34 monitored beds, treating 50,000 patients/year with a staff to patient unit of service of 2.26.

Participants: Three critical positions in the department were identified: The Charge Nurse; Triage Nurse; and Lead Physician. Using existing staff, two additional triage nurses were activated for a total of three nurses. No new positions were added. The physician's schedules were moved up an hour to provide more physician coverage earlier in the day. ED Registration began STAT registration on all patients.

Methods: The 24 hr operation is treated like an engine. To operate the engine, five gears were created with distinct actions that differ in each gear. The gears are directly related to the volume of patients in the department. The Charge Nurse, Lead Triage Nurse, and Lead Physician conducted board rounds every two hours or sooner as needed to call the gear. The gear would then be announced over head in the department to communicate the current work flow to all staff members. A group of rooms were designated as the Initial Patient Contact area (IPC) which is an adjunct to triage and run by the three triage nurses.

Results: Result data is from the six month average before implementation of the new process compared to the six month average after implementation. Patient satisfaction reflects the quarter before and the quarter after implementation:

Arrival to physician time decreased 31% - 71min/44 min;
Patients LWBS decreased 49% - 112 patients/58 patients;
Diversion Hrs no change - 62 hrs/62 hrs;
Patients seen increased 11% - 146 ADC/164 ADC;
Patient satisfaction increased 1.5 points - 82.4/83.9.

Recommendation: The data abstracted from this project supported the purpose in four of the five measures. An empty waiting room at 5:00pm on a Friday night is quite a site to behold.
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 Reality of Immediate Bedding; Journey Through the Looking Glassen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162696-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Reality of Immediate Bedding; Journey Through the Looking Glass</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">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Godfrey, Marcus, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Sutter Roseville Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Manager, Emergency Department</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1 Medical Plaza, Roseville, CA, 95661-3037, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(916) 781-1366</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">godfrem@sutterhealth.org</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Immediate bedding can be the answer to decreasing arrival to physician times, Left Without Being Seen (LWBS), ambulance diversion; and a sound business plan for volume growth to increase market share in a competitive healthcare market. Arrival to physician time standards are decreasing and the concept of triage nurse as the sole gate keeper of the department is antiquated.<br/><br/>Design: This is a process improvement project involving the ED Physicians and Charge Nurses. They were given the task to find a solution to immediate bedding. <br/><br/>Setting: This is a suburban level II trauma center/ level II emergency department with 34 monitored beds, treating 50,000 patients/year with a staff to patient unit of service of 2.26.<br/><br/>Participants: Three critical positions in the department were identified: The Charge Nurse; Triage Nurse; and Lead Physician. Using existing staff, two additional triage nurses were activated for a total of three nurses. No new positions were added. The physician's schedules were moved up an hour to provide more physician coverage earlier in the day. ED Registration began STAT registration on all patients.<br/><br/>Methods: The 24 hr operation is treated like an engine. To operate the engine, five gears were created with distinct actions that differ in each gear. The gears are directly related to the volume of patients in the department. The Charge Nurse, Lead Triage Nurse, and Lead Physician conducted board rounds every two hours or sooner as needed to call the gear. The gear would then be announced over head in the department to communicate the current work flow to all staff members. A group of rooms were designated as the Initial Patient Contact area (IPC) which is an adjunct to triage and run by the three triage nurses.<br/><br/>Results: Result data is from the six month average before implementation of the new process compared to the six month average after implementation. Patient satisfaction reflects the quarter before and the quarter after implementation:<br/> <br/> Arrival to physician time decreased 31% - 71min/44 min; <br/> Patients LWBS decreased 49% - 112 patients/58 patients;<br/> Diversion Hrs no change - 62 hrs/62 hrs;<br/> Patients seen increased 11% - 146 ADC/164 ADC;<br/> Patient satisfaction increased 1.5 points - 82.4/83.9.<br/><br/>Recommendation: The data abstracted from this project supported the purpose in four of the five measures. An empty waiting room at 5:00pm on a Friday night is quite a site to behold.</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:36Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:36Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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