2.50
Hdl Handle:
http://hdl.handle.net/10755/162793
Type:
Presentation
Title:
Emergency Department Re-engineering Project
Abstract:
Emergency Department Re-engineering Project
Conference Sponsor:Emergency Nurses Association
Conference Year:1998
Author:Taylor, Candace, RN, BSN, CEN
P.I. Institution Name:UCSD Medical Center
Contact Address:, San Diego, CA, 92109, USA
Co-Authors:David Guss, MD, FACP, FAEEM
Purpose: An emergency department (ED) Re-engineering Team was formed to improve the ED patient flow process. The objectives of the redesign were to decrease: (1) total turnaround time (initial contact to departure), all patients, (2) total turnaround time, non-emergent patients, (3) wait time (from triage to disposition), all patients, (4) wait time, non-emergent patients, (5) wait time, patients admitted, and (6) decrease the number of patients left without being seen.

Design: This was a prospective study, with time motion analysis pre and post re-engineering of the patient flow process.

Setting: A tertiary, urban, University Medical Center with a census of 33,000/yr was used for this study. Payor mix included 22% non-sponsored, 34% sponsored, and 39% state/county funded.

Sample: All patients entering the ED needing emergent or non-emergent care were included over a period of 5 months, 24 hrs/day, 7 days/wk during the spring to summer months.

Methodology: The Re-engineering Team was comprised of: 1 RN, 1 Clerk, 1 EMT, 1 RN Coach, 2 Attendings, and 1 Resident. Re-engineering strategies included: (1) flow chart of current patient flow process and identified wait times, (2) time motion study through computer charting system of all patients, (3) benchmark of other area hospitals, (4) developed a new patient flow process, (5) a time motion study was done 6 weeks prior to pre-change (T-1), (6) a time motion study was completed 2-3 weeks post-change (T- 2). Change strategies included: augmented support in triage, change and reassignment of acuity categories, re-designation of all beds, immediate placement to ED bed from triage, and bedside registration.

Results: Statistical significance for average times calculated for each variable for pre and post intervals was determined using the studentÆs t-test. Total turnaround time for all patients was unchanged, however, non-emergent patients improved (2.5 to 2.1), (p < .004). Wait times for all patients decreased (39.2 to 5.8), (p < .0001), including wait times for non-emergent patients (53.5 to 6.1) (p < .0001), and patients that were admitted (18 to 4.6), (p < .0001). The percentage of patients that left without being seen decreased (4.0% to 1.5%), (p = .00).

Conclusions: The goals of decreasing wait time and decreasing patients that left without being seen were successfully accomplished with implementation of changes made to the patient flow process. [Leadership Challenge - Research 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.titleEmergency Department Re-engineering Projecten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162793-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Department Re-engineering Project</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">1998</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Taylor, Candace, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">UCSD Medical Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, San Diego, CA, 92109, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">David Guss, MD, FACP, FAEEM</td></tr><tr><td colspan="2" class="item-abstract">Purpose: An emergency department (ED) Re-engineering Team was formed to improve the ED patient flow process. The objectives of the redesign were to decrease: (1) total turnaround time (initial contact to departure), all patients, (2) total turnaround time, non-emergent patients, (3) wait time (from triage to disposition), all patients, (4) wait time, non-emergent patients, (5) wait time, patients admitted, and (6) decrease the number of patients left without being seen.<br/><br/>Design: This was a prospective study, with time motion analysis pre and post re-engineering of the patient flow process.<br/><br/>Setting: A tertiary, urban, University Medical Center with a census of 33,000/yr was used for this study. Payor mix included 22% non-sponsored, 34% sponsored, and 39% state/county funded.<br/><br/>Sample: All patients entering the ED needing emergent or non-emergent care were included over a period of 5 months, 24 hrs/day, 7 days/wk during the spring to summer months.<br/><br/>Methodology: The Re-engineering Team was comprised of: 1 RN, 1 Clerk, 1 EMT, 1 RN Coach, 2 Attendings, and 1 Resident. Re-engineering strategies included: (1) flow chart of current patient flow process and identified wait times, (2) time motion study through computer charting system of all patients, (3) benchmark of other area hospitals, (4) developed a new patient flow process, (5) a time motion study was done 6 weeks prior to pre-change (T-1), (6) a time motion study was completed 2-3 weeks post-change (T- 2). Change strategies included: augmented support in triage, change and reassignment of acuity categories, re-designation of all beds, immediate placement to ED bed from triage, and bedside registration.<br/><br/>Results: Statistical significance for average times calculated for each variable for pre and post intervals was determined using the student&AElig;s t-test. Total turnaround time for all patients was unchanged, however, non-emergent patients improved (2.5 to 2.1), (p &lt; .004). Wait times for all patients decreased (39.2 to 5.8), (p &lt; .0001), including wait times for non-emergent patients (53.5 to 6.1) (p &lt; .0001), and patients that were admitted (18 to 4.6), (p &lt; .0001). The percentage of patients that left without being seen decreased (4.0% to 1.5%), (p = .00).<br/><br/>Conclusions: The goals of decreasing wait time and decreasing patients that left without being seen were successfully accomplished with implementation of changes made to the patient flow process. [Leadership Challenge - Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:34:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:34:15Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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