2.50
Hdl Handle:
http://hdl.handle.net/10755/162920
Type:
Presentation
Title:
Nursing Turns the Tide: The Triage Plus Plan
Abstract:
Nursing Turns the Tide: The Triage Plus Plan
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Schneider, Carla, RN, BSN, MICN, CEN
P.I. Institution Name:Hoag Memorial Hospital Presbyterian
Title:Emergency Department Director
Contact Address:One Hoag Dr., Newport Beach, CA, 92658, USA
Contact Telephone:(949) 764-5926
Purpose: According to the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), more than one half of sentinel events in the emergency department (ED) are related to delays in treatment. Increased throughput time based on ED overcrowding and patient holding results in an increased risk of deterioration in the patient's condition and in the public's "safety net" of emergency care. The hospital in this study implemented a "Triage Plus Plan" on March 14, 2005 to improve patient care by reducing wait time and delays in treatment. The process is initiated when treatment beds are full and more than three patients are waiting in the ED lobby for 30 minutes or more. Daily census by hour reflected that most patients enter the ED from 11AM to 11PM, requiring an additional emergency nurse, who is provided under the Triage Plus Plan. The triage team of a physician, nurse, and phlebotomist perform the preliminary exam, place orders, and initiate labs before the patient is returned to the lobby. Patients are called from the lobby for radiology tests and frequently, by the time a treatment bed becomes available, the tests are resulted. The purpose of this study was to evaluate the impact of the Triage Plus Plan on decreasing wait times and delays in treatment.
Design/Setting/Sample: This was a retrospective quantitative study of patients who presented to a 32-bed ED in Southern California during the high census timeframe between 11 AM and 11 PM. Methodology: Computerized patient records were audited for the year prior to implementation of the Triage Plus Plan (March 2004 through March 2005) and a comparative study was performed on patient records for the first year of the Plan's implementation (March 2005 through March 2006). The primary focus was on wait times and delays in treatments. Results: The evaluation of the Triage Plus Plan reflected the following outcomes: 1) door-to-treatment time was reduced from 45 to 38 minutes, 2) transaction time from patient arrival through discharge was reduced by 6 minutes, and 3) the percentage of emergent patients escorted to the treatment area within 15 minutes of presenting to the ED increased from 92.71% to 96.55%. Although not directly related to wait times, the study also found early recognition of emergent patients based on critical lab values. Conclusions: A reduction in transaction time and increased, timely access to the healthcare team in the ED may improve patient throughput and care. Interventions such as the Triage Plus Plan should be explored and developed to alleviate crowding and enhance the public's access to the safety net of emergency care. [Research 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.titleNursing Turns the Tide: The Triage Plus Planen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162920-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Nursing Turns the Tide: The Triage Plus Plan</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">Schneider, Carla, RN, BSN, MICN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Hoag Memorial Hospital Presbyterian</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Department Director</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">One Hoag Dr., Newport Beach, CA, 92658, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(949) 764-5926</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Carla.Schneider@hoaghospital.org</td></tr><tr><td colspan="2" class="item-abstract">Purpose: According to the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), more than one half of sentinel events in the emergency department (ED) are related to delays in treatment. Increased throughput time based on ED overcrowding and patient holding results in an increased risk of deterioration in the patient's condition and in the public's &quot;safety net&quot; of emergency care. The hospital in this study implemented a &quot;Triage Plus Plan&quot; on March 14, 2005 to improve patient care by reducing wait time and delays in treatment. The process is initiated when treatment beds are full and more than three patients are waiting in the ED lobby for 30 minutes or more. Daily census by hour reflected that most patients enter the ED from 11AM to 11PM, requiring an additional emergency nurse, who is provided under the Triage Plus Plan. The triage team of a physician, nurse, and phlebotomist perform the preliminary exam, place orders, and initiate labs before the patient is returned to the lobby. Patients are called from the lobby for radiology tests and frequently, by the time a treatment bed becomes available, the tests are resulted. The purpose of this study was to evaluate the impact of the Triage Plus Plan on decreasing wait times and delays in treatment. <br/>Design/Setting/Sample: This was a retrospective quantitative study of patients who presented to a 32-bed ED in Southern California during the high census timeframe between 11 AM and 11 PM. Methodology: Computerized patient records were audited for the year prior to implementation of the Triage Plus Plan (March 2004 through March 2005) and a comparative study was performed on patient records for the first year of the Plan's implementation (March 2005 through March 2006). The primary focus was on wait times and delays in treatments. Results: The evaluation of the Triage Plus Plan reflected the following outcomes: 1) door-to-treatment time was reduced from 45 to 38 minutes, 2) transaction time from patient arrival through discharge was reduced by 6 minutes, and 3) the percentage of emergent patients escorted to the treatment area within 15 minutes of presenting to the ED increased from 92.71% to 96.55%. Although not directly related to wait times, the study also found early recognition of emergent patients based on critical lab values. Conclusions: A reduction in transaction time and increased, timely access to the healthcare team in the ED may improve patient throughput and care. Interventions such as the Triage Plus Plan should be explored and developed to alleviate crowding and enhance the public's access to the safety net of emergency care. [Research Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:26Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:26Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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