Emergency Department Single-point-of-Discharge, Improving Satisfaction and Quality

2.50
Hdl Handle:
http://hdl.handle.net/10755/162922
Type:
Presentation
Title:
Emergency Department Single-point-of-Discharge, Improving Satisfaction and Quality
Abstract:
Emergency Department Single-point-of-Discharge, Improving Satisfaction and Quality
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Steinmuss, Joy, RN
P.I. Institution Name:Mission Hospitals
Title:Emergency Department Single-Point-of-Discharge Champion
Contact Address:509 Biltmore Ave., Asheville, NC, 28801, USA
Contact Telephone:(828) 213-0751
Co-Authors:Kaye Culberson, RN, MSN
Clinical Topic: The current discharge process (at this Level II trauma center in North Carolina with quarterly patient volumes greater than 20,000) was not as effective as it could be. Quite often, follow-up appointments were not scheduled, physician referrals were not completed, community resources were not communicated, patients left without paying or providing billing information, responses from patient satisfaction surveys were too few for confidence in results, and documentation of patient education was absent. The purpose of this study was to determine if an emergency department (ED) Single-Point-of-Discharge (SPD) would improve the effectiveness of the discharge process. Implementation: A nurse-led team was established in January 2003 to investigate the feasibility of the SPD concept. The team wrote a project charter; developed role descriptions for SPD discharge clerks and registered nurses (RNs); received a grant for $181,330; redesigned physical space; developed SPD forms; and tailored the patient satisfaction survey to capture SPD events. SPD RNs provided patient education and assisted with community referrals and follow-up appointments; SPD Clerks and RNs addressed service recovery and patient advocacy; and SPD Clerks collected surveys and payments. All discharged urgent and non-urgent ED patients were scheduled for discharge through SPD. Patient satisfaction was measured using the Jackson Group Patient Satisfaction Survey. Data was collected on the following: patient education; service recovery; patient advocacy; community referrals; documentation compliance; SPD eligibility; collections; patient volumes; and unplanned returns. Outcomes: In September of 2003, the project began on one campus with a SPD discharge clerk (the addition of a registered nurse was pending FTE approval). In August 2004, the pilot expanded to a second campus and included a SPD RN. In the first six months, 93% of eligible patients were discharged through SPD. Staff and patient noncompliance with the newly implemented SPD process accounted for the remaining 7%. Responses to patient satisfaction surveys increased from 337 to 3,160. The community referral base increased from eight to 35. Referrals to community programs increased from 38 to 548. With a process in place for ED collections, collections rose from zero to more than $39,000 per quarter. Unplanned returns decreased from 13.7% to 12.65%. Audits are ongoing for patient education and documentation compliance. One unanticipated weakness in the SPD process, excess time required for nurse documentation, was resolved by developing a SPD nurses? note. Unanticipated benefits of the process included development of partnerships with community agencies, and increased access to dental care for Medicaid and uninsured low-income patients. Recommendations: ED Single-Point-of-Discharge increased responses to patient satisfaction surveys, referrals to community programs, and payments while decreasing unplanned returns. Additionally, ED Single-Point-of-Discharge allows service recovery and advocacy opportunities to be addressed in real time. Implementing SPD discharge clerks and registered nurses allow emergency nurses more time to care for patients. Patients discharged from Single-Point-of-Discharge report improved satisfaction with education provided and with their overall ED experience.
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 Single-point-of-Discharge, Improving Satisfaction and Qualityen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162922-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Department Single-point-of-Discharge, Improving Satisfaction and Quality</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">Steinmuss, Joy, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mission Hospitals</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Department Single-Point-of-Discharge Champion</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">509 Biltmore Ave., Asheville, NC, 28801, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(828) 213-0751</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jsteinmuss@charter.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kaye Culberson, RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: The current discharge process (at this Level II trauma center in North Carolina with quarterly patient volumes greater than 20,000) was not as effective as it could be. Quite often, follow-up appointments were not scheduled, physician referrals were not completed, community resources were not communicated, patients left without paying or providing billing information, responses from patient satisfaction surveys were too few for confidence in results, and documentation of patient education was absent. The purpose of this study was to determine if an emergency department (ED) Single-Point-of-Discharge (SPD) would improve the effectiveness of the discharge process. Implementation: A nurse-led team was established in January 2003 to investigate the feasibility of the SPD concept. The team wrote a project charter; developed role descriptions for SPD discharge clerks and registered nurses (RNs); received a grant for $181,330; redesigned physical space; developed SPD forms; and tailored the patient satisfaction survey to capture SPD events. SPD RNs provided patient education and assisted with community referrals and follow-up appointments; SPD Clerks and RNs addressed service recovery and patient advocacy; and SPD Clerks collected surveys and payments. All discharged urgent and non-urgent ED patients were scheduled for discharge through SPD. Patient satisfaction was measured using the Jackson Group Patient Satisfaction Survey. Data was collected on the following: patient education; service recovery; patient advocacy; community referrals; documentation compliance; SPD eligibility; collections; patient volumes; and unplanned returns. Outcomes: In September of 2003, the project began on one campus with a SPD discharge clerk (the addition of a registered nurse was pending FTE approval). In August 2004, the pilot expanded to a second campus and included a SPD RN. In the first six months, 93% of eligible patients were discharged through SPD. Staff and patient noncompliance with the newly implemented SPD process accounted for the remaining 7%. Responses to patient satisfaction surveys increased from 337 to 3,160. The community referral base increased from eight to 35. Referrals to community programs increased from 38 to 548. With a process in place for ED collections, collections rose from zero to more than $39,000 per quarter. Unplanned returns decreased from 13.7% to 12.65%. Audits are ongoing for patient education and documentation compliance. One unanticipated weakness in the SPD process, excess time required for nurse documentation, was resolved by developing a SPD nurses? note. Unanticipated benefits of the process included development of partnerships with community agencies, and increased access to dental care for Medicaid and uninsured low-income patients. Recommendations: ED Single-Point-of-Discharge increased responses to patient satisfaction surveys, referrals to community programs, and payments while decreasing unplanned returns. Additionally, ED Single-Point-of-Discharge allows service recovery and advocacy opportunities to be addressed in real time. Implementing SPD discharge clerks and registered nurses allow emergency nurses more time to care for patients. Patients discharged from Single-Point-of-Discharge report improved satisfaction with education provided and with their overall ED experience.</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:28Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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