2.50
Hdl Handle:
http://hdl.handle.net/10755/162992
Type:
Presentation
Title:
Patient Flow Redesign
Abstract:
Patient Flow Redesign
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:McAllen, Susan, RN, MS, CEN
P.I. Institution Name:Montefiore Medical Center
Title:Administrative Nurse Manager
Contact Address:111 East 210th St., Bronx, NY, 10467, USA
Contact Telephone:(718) 920-2601
Co-Authors:Peter Stalter, RN; Kathleen Hart, RN, MSOL
Clinical Topic: In 2002, the emergency department (ED) of Montefiore Medical Center in Bronx, NY, was identified as the 15th-busiest emergency department in the United States by the American Hospital Association (AHA) Annual Survey of Hospitals. To meet the demand of the increased volume, a more efficient method for rapid and accurate sorting of incoming patients was needed. A plan was developed to initiate a five-level triage acuity rating scale. However, the patient-flow process in the emergency department needed to be addressed prior to implementing the new scale.
Implementation: A multidisciplinary task force, comprised of nursing leadership, staff nurses, and physicians, was formed to assess current patient-flow practices in the emergency department and to identify strategies for improvements. Priorities that needed to be addressed to improve patient flow from triage included: 1) Patient time spent between triage and contact with attending physician; and 2) Equitability among nurses regarding patient-care assignments. To decrease the amount of time spent between triage and contact with an attending physician for patients in need of urgent care, a diagnostic-care team comprised of an attending physician, a nurse, and a patient-care technician was formed. A nursing-assignment workflow board was developed and implemented to address equitability. This magnetic board was posted in the emergency department to organize and manage patient-care assignments and workflow. Over a two-week period, nursing leadership educated the multidisciplinary care team and implemented the redesigned patient-flow process in the emergency department using a preceptor model 24 hours a day, 7 days a week. Outcomes: Both the diagnostic-care team and the nursing-assignment workflow board improved patient flow from triage. Since implementing the redesigned patient-flow process, the following parameters have been on the decline: Length of stay; triage to physician contact time for urgent patients; patient elopements; and staff complaints regarding equitability of patient- care assignments. Recommendations: Redesigning ED patient flow to include a diagnostic-care team and a nursing-assignment workflow board can improve patient flow and increase satisfaction among patients and staff. The patient-flow redesign begins in triage and ends with patient discharge. Following the initiation of the patient-flow redesign at our facility, a five-level triage acuity rating scale was implemented, and plans now are being developed to address the final process - patient discharge. Efforts are underway to expand the hours of operation for the diagnostic team. Evaluation of internal and external customer satisfaction, length of stay, triage to physician contact time, and patient elopement will continue.
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.titlePatient Flow Redesignen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162992-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patient Flow Redesign</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">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McAllen, Susan, RN, MS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Montefiore Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Administrative Nurse Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">111 East 210th St., Bronx, NY, 10467, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(718) 920-2601</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">smcallen@montefiore.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Peter Stalter, RN; Kathleen Hart, RN, MSOL<br/></td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: In 2002, the emergency department (ED) of Montefiore Medical Center in Bronx, NY, was identified as the 15th-busiest emergency department in the United States by the American Hospital Association (AHA) Annual Survey of Hospitals. To meet the demand of the increased volume, a more efficient method for rapid and accurate sorting of incoming patients was needed. A plan was developed to initiate a five-level triage acuity rating scale. However, the patient-flow process in the emergency department needed to be addressed prior to implementing the new scale. <br/>Implementation: A multidisciplinary task force, comprised of nursing leadership, staff nurses, and physicians, was formed to assess current patient-flow practices in the emergency department and to identify strategies for improvements. Priorities that needed to be addressed to improve patient flow from triage included: 1) Patient time spent between triage and contact with attending physician; and 2) Equitability among nurses regarding patient-care assignments. To decrease the amount of time spent between triage and contact with an attending physician for patients in need of urgent care, a diagnostic-care team comprised of an attending physician, a nurse, and a patient-care technician was formed. A nursing-assignment workflow board was developed and implemented to address equitability. This magnetic board was posted in the emergency department to organize and manage patient-care assignments and workflow. Over a two-week period, nursing leadership educated the multidisciplinary care team and implemented the redesigned patient-flow process in the emergency department using a preceptor model 24 hours a day, 7 days a week. Outcomes: Both the diagnostic-care team and the nursing-assignment workflow board improved patient flow from triage. Since implementing the redesigned patient-flow process, the following parameters have been on the decline: Length of stay; triage to physician contact time for urgent patients; patient elopements; and staff complaints regarding equitability of patient- care assignments. Recommendations: Redesigning ED patient flow to include a diagnostic-care team and a nursing-assignment workflow board can improve patient flow and increase satisfaction among patients and staff. The patient-flow redesign begins in triage and ends with patient discharge. Following the initiation of the patient-flow redesign at our facility, a five-level triage acuity rating scale was implemented, and plans now are being developed to address the final process - patient discharge. Efforts are underway to expand the hours of operation for the diagnostic team. Evaluation of internal and external customer satisfaction, length of stay, triage to physician contact time, and patient elopement will continue.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:41Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:41Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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