2.50
Hdl Handle:
http://hdl.handle.net/10755/162902
Type:
Presentation
Title:
Implementing Emergency Department Throughput: One Medical Center's Initiative
Abstract:
Implementing Emergency Department Throughput: One Medical Center's Initiative
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Gniady, Mary, RN, MS, APRN, NP-C, CCNS, CEN
P.I. Institution Name:Provena St. Joseph Medical Center
Title:Patient Care Manager
Contact Address:333 Madison, Joliet, IL, 60435, USA
Contact Telephone:(815) 725-7133
Co-Authors:Mary Gniady, RN, MS, APRN, NP-C, CCNS, CEN
Clinical Topic: Delayed nurse reports and unnecessary triage led to long waits, high volumes of LWBS (left without being seen) and decreased patient visits at this Midwest emergency department with a staff of more than 136, serving 63,000 patients a year. To address these problems, in 2005 senior leadership enlisted the help of outside consultants, and in May 2005, this 459-bed medical facility implemented its $2 million Throughput Initiative. The initiative's overall goal was to create a seamless, efficient, patient-centered system that would improve patient flow and result in more timely and efficient care. Specific objectives included treating and releasing patients in less than 3 hours, admitting patients in less than 4 hours, and increasing annual volume of ER visits. By achieving these goals, we expected to improve service to all patients, create an efficient and flexible work environment, and increase patient, staff and physician satisfaction. Implementation: To meet our objectives, four multidisciplinary teams were formed, although only the ER Redesign Team required involvement of all ER staff. (Other teams included the Care Management Team, the Patient Placement-Bed Management Team, and the Central Transport Team.) To address patient flow, the ER team redesigned processes, from entry to exit. Improvements included streamlining patient reception, establishing "quick look" rapid room placement, enhancing protocols (such as reviewing and improving "fast track" or "Express Care" criteria), initiating bedside registration, developing a means to ensure admissions meet InterQual criteria for diagnosis and placement, employing a patient transport system, instituting co-pay collection, and enhancing hand-offs via a voice dictation system with a "no refusal" expectation for use when inpatient RNs cannot receive reports by phone. New roles were added and defined to implement these changes and included valet, ambassador (to direct patients to ER), "quick look RN" (to categorize and assign beds, based on presenting complaint), patient mover (to escort patient to assigned treatment room for initial assessment), bedside registrar, and clinical resource nurse (to determine appropriate level of care using InterQual criteria). Outcomes: Since implementing the Throughput Initiative, we have dramatically decreased turnaround times and LWBS volume, thus improving patient satisfaction and care. For the period of May 2005 to December 2005, LWBS volume improved, decreasing from 4% to 0.6%; ED patients treated and released in less than 3 hours rose from 62% in May 2005 to 66% December 2005 to 73% YTD 2006; the number of Fast Track patients treated and released in less than 90 minutes increased from 65% in May 2005 to 68% December 2005 to 79% YTD 2006; and patents treated and admitted in less than 4 hours climbed to 64.7%. What is more, ER visits rose from May to December 2005, by 3.76%, and from May 2005 through March 2006, by 5.3%. Patient Satisfaction scores also rose in 2005, from 30% in the first quarter to 92% in the fourth quarter as measured by Press Ganey ER Survey.
Recommendations: By taking charge of our throughput problems, our staff has established accountability for the ED, taking ownership of ED processes. An intense team effort such as ours can transform facilities in general, and the ED in particular, into high-quality, streamlined systems of care. We continue to celebrate our successes and conduct ongoing patient and staff surveys to ensure excellence in providing our community with high quality and timely care.
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.titleImplementing Emergency Department Throughput: One Medical Center's Initiativeen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162902-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementing Emergency Department Throughput: One Medical Center's Initiative</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">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gniady, Mary, RN, MS, APRN, NP-C, CCNS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Provena St. Joseph Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Patient Care Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">333 Madison, Joliet, IL, 60435, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(815) 725-7133</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">maryegniady@provenahealth.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary Gniady, RN, MS, APRN, NP-C, CCNS, CEN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: Delayed nurse reports and unnecessary triage led to long waits, high volumes of LWBS (left without being seen) and decreased patient visits at this Midwest emergency department with a staff of more than 136, serving 63,000 patients a year. To address these problems, in 2005 senior leadership enlisted the help of outside consultants, and in May 2005, this 459-bed medical facility implemented its $2 million Throughput Initiative. The initiative's overall goal was to create a seamless, efficient, patient-centered system that would improve patient flow and result in more timely and efficient care. Specific objectives included treating and releasing patients in less than 3 hours, admitting patients in less than 4 hours, and increasing annual volume of ER visits. By achieving these goals, we expected to improve service to all patients, create an efficient and flexible work environment, and increase patient, staff and physician satisfaction. Implementation: To meet our objectives, four multidisciplinary teams were formed, although only the ER Redesign Team required involvement of all ER staff. (Other teams included the Care Management Team, the Patient Placement-Bed Management Team, and the Central Transport Team.) To address patient flow, the ER team redesigned processes, from entry to exit. Improvements included streamlining patient reception, establishing &quot;quick look&quot; rapid room placement, enhancing protocols (such as reviewing and improving &quot;fast track&quot; or &quot;Express Care&quot; criteria), initiating bedside registration, developing a means to ensure admissions meet InterQual criteria for diagnosis and placement, employing a patient transport system, instituting co-pay collection, and enhancing hand-offs via a voice dictation system with a &quot;no refusal&quot; expectation for use when inpatient RNs cannot receive reports by phone. New roles were added and defined to implement these changes and included valet, ambassador (to direct patients to ER), &quot;quick look RN&quot; (to categorize and assign beds, based on presenting complaint), patient mover (to escort patient to assigned treatment room for initial assessment), bedside registrar, and clinical resource nurse (to determine appropriate level of care using InterQual criteria). Outcomes: Since implementing the Throughput Initiative, we have dramatically decreased turnaround times and LWBS volume, thus improving patient satisfaction and care. For the period of May 2005 to December 2005, LWBS volume improved, decreasing from 4% to 0.6%; ED patients treated and released in less than 3 hours rose from 62% in May 2005 to 66% December 2005 to 73% YTD 2006; the number of Fast Track patients treated and released in less than 90 minutes increased from 65% in May 2005 to 68% December 2005 to 79% YTD 2006; and patents treated and admitted in less than 4 hours climbed to 64.7%. What is more, ER visits rose from May to December 2005, by 3.76%, and from May 2005 through March 2006, by 5.3%. Patient Satisfaction scores also rose in 2005, from 30% in the first quarter to 92% in the fourth quarter as measured by Press Ganey ER Survey. <br/>Recommendations: By taking charge of our throughput problems, our staff has established accountability for the ED, taking ownership of ED processes. An intense team effort such as ours can transform facilities in general, and the ED in particular, into high-quality, streamlined systems of care. We continue to celebrate our successes and conduct ongoing patient and staff surveys to ensure excellence in providing our community with high quality and timely care.</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:06Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:06Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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