2.50
Hdl Handle:
http://hdl.handle.net/10755/163020
Type:
Presentation
Title:
Creating a New and Improved Triage Process
Abstract:
Creating a New and Improved Triage Process
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Kubbins, Amy, RN, BSN, CEN
P.I. Institution Name:Aultman Health Foundation
Title:Patient Care Specialist
Contact Address:2600 6th Street SW, Canton, OH, 44710, USA
Contact Telephone:(330) 363-6788
Co-Authors:Debby Taylor, RN, MBA; Carolyn Boeckling, RN, BSN, CEN; Nancy Koehler, RN, CEN
Purpose: Press Ganey surveys revealed overall emergency department (ED) customer satisfaction with wait times at the 58th percentile. Identifying triage as the ED access point for patients not transported by ambulance clearly made it an obvious area to examine customer service, patient flow patterns, and current protocol for triaging patients into treatment categories. Reducing the time before treatment was implemented should improve ED patient flow. Increasing patient triage efficiency and reducing numbers of patients leaving before treatment should increase patient satisfaction. Design: An institution defined performance improvement project focused on the efficiency of the current triage process and patient flow upon arrival at the emergency department. Variables that were considered included: emergency department turnaround time, current triage protocols and their impact upon patient flow, average ED triage waits times, complaints related to triage, and the number of patients leaving before treatment in the emergency department. Setting: The setting was a Level II Trauma Center and teaching facility located in an urban community in the Midwest. Participants: Nurses interested in a triage specialty formed the core team based on triage skills, customer satisfaction skills, and experience in nursing. From the eighty nurses surveyed, twenty-five registered nurses met the requirements who then received education specifically focused on customer relations, service recovery, and primary assessment skills. An ED triage council, consisting of the ED medical director, unit director, two patient care specialists, and five staff nurses, were responsible for project implementation and evaluation. Methods: Training and implementation process occurred over a one month period. Four treatment rooms were designated as basic care to facilitate movement of patients triaged as non-emergent (ESI Level I & II). Triage staffing was increase to two registered nurses and one technician. Tracking basic care turnaround time, patient wait time in triage, customer satisfaction scores, and overall patient flow was the method of evaluation for the new triage process. Results: Patient wait times decreased from 36 minutes to 25 minutes with turnaround time of the basic care rooms at 1.3 hours. Patient satisfaction, per Press Ganey, increased from 58th percentile to 81st percentile with a 50% decrease in the number of patient complaints related to triage process and patient wait. Patients that left without being seen decreased by 35%. Barriers identified included staffing consistency to ensure two triage nurses, the small pool of triage trained nurses, and the need for triage protocols. Recommendations: Further identification of other potential influences on patient satisfaction is critical. Additional training of all triage and registration staff in customer service skills and triage process ensures consistency. Incorporating an ED greeter role would facilitate positive front door patient perception. Triage protocols would allow treatment to begin at triage.
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.titleCreating a New and Improved Triage Processen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163020-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Creating a New and Improved Triage Process</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">Kubbins, Amy, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Aultman Health Foundation</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Patient Care Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2600 6th Street SW, Canton, OH, 44710, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(330) 363-6788</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Kubs921@sbcglobal.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Debby Taylor, RN, MBA; Carolyn Boeckling, RN, BSN, CEN; Nancy Koehler, RN, CEN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Press Ganey surveys revealed overall emergency department (ED) customer satisfaction with wait times at the 58th percentile. Identifying triage as the ED access point for patients not transported by ambulance clearly made it an obvious area to examine customer service, patient flow patterns, and current protocol for triaging patients into treatment categories. Reducing the time before treatment was implemented should improve ED patient flow. Increasing patient triage efficiency and reducing numbers of patients leaving before treatment should increase patient satisfaction. Design: An institution defined performance improvement project focused on the efficiency of the current triage process and patient flow upon arrival at the emergency department. Variables that were considered included: emergency department turnaround time, current triage protocols and their impact upon patient flow, average ED triage waits times, complaints related to triage, and the number of patients leaving before treatment in the emergency department. Setting: The setting was a Level II Trauma Center and teaching facility located in an urban community in the Midwest. Participants: Nurses interested in a triage specialty formed the core team based on triage skills, customer satisfaction skills, and experience in nursing. From the eighty nurses surveyed, twenty-five registered nurses met the requirements who then received education specifically focused on customer relations, service recovery, and primary assessment skills. An ED triage council, consisting of the ED medical director, unit director, two patient care specialists, and five staff nurses, were responsible for project implementation and evaluation. Methods: Training and implementation process occurred over a one month period. Four treatment rooms were designated as basic care to facilitate movement of patients triaged as non-emergent (ESI Level I &amp; II). Triage staffing was increase to two registered nurses and one technician. Tracking basic care turnaround time, patient wait time in triage, customer satisfaction scores, and overall patient flow was the method of evaluation for the new triage process. Results: Patient wait times decreased from 36 minutes to 25 minutes with turnaround time of the basic care rooms at 1.3 hours. Patient satisfaction, per Press Ganey, increased from 58th percentile to 81st percentile with a 50% decrease in the number of patient complaints related to triage process and patient wait. Patients that left without being seen decreased by 35%. Barriers identified included staffing consistency to ensure two triage nurses, the small pool of triage trained nurses, and the need for triage protocols. Recommendations: Further identification of other potential influences on patient satisfaction is critical. Additional training of all triage and registration staff in customer service skills and triage process ensures consistency. Incorporating an ED greeter role would facilitate positive front door patient perception. Triage protocols would allow treatment to begin at triage.</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:10Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:10Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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