2.50
Hdl Handle:
http://hdl.handle.net/10755/162738
Type:
Presentation
Title:
Triage: Redesign and Process Improvement
Abstract:
Triage: Redesign and Process Improvement
Conference Sponsor:Emergency Nurses Association
Conference Year:2000
Author:Buraczewski, Michele, RN, MSN, CEN
P.I. Institution Name:Mercy Hospital of Pittsburgh
Contact Address:1400 Locust Street, Pittsburgh, PA, 15219, USA
Contact Telephone:(412) 232-8168
Co-Authors:Gail Pupo and Shannon Smerbeck
Clinical Topic: The goal of this clinical project was to improve the quality of care for patients at triage. The triage process demanded attention and improvement with the identification of longer than expected waiting times for urgent patients, and evidence of medical legal risks.

Implementation: A triage process improvement team was formed to focus on quality improvement efforts. Areas which were identified for improvement included triage redesign, patient registration, nursing education, and family communication. A quality monitor was developed to review charts for:

1) Patient triage acuity documented;
2) Patient triage acuity documented accurately by triage RN based on review of patient chief complaint,
symptoms, and vital sign;
3) Patient triage acuity identified by triage RN as "urgent"; and
4) Patient triage acuity identified by triage RN as "urgent' placed in treatment room or rechecked every
30 minutes while in waiting room.

This monitor was started in March 1999 and was completed monthly with staff involvement in reviewing of the documentation. Education of 20 RNs began in May 1999 with the ENA's Making the Right Decision - A Triage Curriculum. The remainder of the staff received the education in the fall of 1999.

Outcomes: Quality monitor results prior to implementing a quality monitor (3/99):

1) 76% compliance (23/30),
2) 91 % compliance (21/23),
3) 66% compliance (14/21), and
4) 40% compliance (6/15)

Based on these results, the staff were re-educated and the QA indicators were shared. To increase compliance, the staff recommended adding a column to the triage logbook to identify if the patient was urgent, and attaching red flag tags to charts in the box waiting to come to a room. The physical plant was looked at to improve visualization of the patients in the waiting area. Quality monitor results after the educational program were:

1) 95% compliance (38/40),
2) 97% compliance (37/38),
3) 90% compliance (36/40), and
4) 75% compliance (27/36)

The results were shared with staff each month.

Recommendations: The Triage Process Improvement Team continues to meet on a regular basis. Our goals are to look at rapid and/or bedside registration, revision of family/visitor policy and to continue triage education to all staff. The QA monitor will continue for the year 2000 and will increase staff involvement on data collection. Education continues monthly and the triage nurses continue to meet and recommend changes in the triage process. [Clinical Poster Presentation]
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.titleTriage: Redesign and Process Improvementen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162738-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Triage: Redesign and Process Improvement</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">2000</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Buraczewski, Michele, RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mercy Hospital of Pittsburgh</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1400 Locust Street, Pittsburgh, PA, 15219, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(412) 232-8168</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mburaczewski@mercy.pmhs.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Gail Pupo and Shannon Smerbeck</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: The goal of this clinical project was to improve the quality of care for patients at triage. The triage process demanded attention and improvement with the identification of longer than expected waiting times for urgent patients, and evidence of medical legal risks.<br/><br/>Implementation: A triage process improvement team was formed to focus on quality improvement efforts. Areas which were identified for improvement included triage redesign, patient registration, nursing education, and family communication. A quality monitor was developed to review charts for:<br/><br/>1) Patient triage acuity documented;<br/>2) Patient triage acuity documented accurately by triage RN based on review of patient chief complaint,<br/> symptoms, and vital sign;<br/>3) Patient triage acuity identified by triage RN as &quot;urgent&quot;; and<br/>4) Patient triage acuity identified by triage RN as &quot;urgent' placed in treatment room or rechecked every<br/>30 minutes while in waiting room.<br/><br/>This monitor was started in March 1999 and was completed monthly with staff involvement in reviewing of the documentation. Education of 20 RNs began in May 1999 with the ENA's Making the Right Decision - A Triage Curriculum. The remainder of the staff received the education in the fall of 1999.<br/><br/>Outcomes: Quality monitor results prior to implementing a quality monitor (3/99):<br/><br/>1) 76% compliance (23/30),<br/>2) 91 % compliance (21/23),<br/>3) 66% compliance (14/21), and <br/>4) 40% compliance (6/15)<br/><br/>Based on these results, the staff were re-educated and the QA indicators were shared. To increase compliance, the staff recommended adding a column to the triage logbook to identify if the patient was urgent, and attaching red flag tags to charts in the box waiting to come to a room. The physical plant was looked at to improve visualization of the patients in the waiting area. Quality monitor results after the educational program were:<br/><br/>1) 95% compliance (38/40), <br/>2) 97% compliance (37/38), <br/>3) 90% compliance (36/40), and <br/>4) 75% compliance (27/36)<br/><br/>The results were shared with staff each month.<br/><br/>Recommendations: The Triage Process Improvement Team continues to meet on a regular basis. Our goals are to look at rapid and/or bedside registration, revision of family/visitor policy and to continue triage education to all staff. The QA monitor will continue for the year 2000 and will increase staff involvement on data collection. Education continues monthly and the triage nurses continue to meet and recommend changes in the triage process. [Clinical Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:19Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:19Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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