2.50
Hdl Handle:
http://hdl.handle.net/10755/163030
Type:
Presentation
Title:
EMTALA and LWBS Population
Abstract:
EMTALA and LWBS Population
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Steffen, Tammy, RN, CEN
P.I. Institution Name:Aurora Sinai Medical Center
Contact Address:2255 E. Michigan Avenue, Oak Creek, WI, 53154, USA
Contact Telephone:(414) 219-3763
Co-Authors:Jeanne Smrz-DuPont, BSN, RN
Purpose: The purpose of this project was to decrease the time from arrival in the emergency department (ED) to initial triage vital signs, thereby decreasing the number of patients who leave the emergency department prior to receiving a medical screening exam, thus lessening exposure to an EMTALA violation. Design: The study was designed as a prospective, interventional comparison. A multidisciplinary team including emergency department, admitting, and information services personnel participated in this study. Setting/subjects: The project was conducted in an urban academic medical center with 64,000 annual ED visits, serving a culturally-diverse population. Methods: Records from all ED visits from 7/01/02 to 09/30/02 were obtained. For patients who had left without being seen (LWBS), the time from arrival to time of initial vital signs calculated. The percentage of the LWBS and the number of EMTALA violations were monitored. From 10/01/02 through 6/30/03, a vital-signs booth was placed at the main triage area with non-physician staff responsible for obtaining initial blood pressure, pulse, respiration, temperature, and pulse oximetry. A nurse practitioner or physician assistant assigned to the triage area performed a medical screening examination on every triage patient in order to determine whether an emergent medical condition existed prior to the patient's decision to leave. Time between arrival and initial vital signs, number of LWBS, and number of EMTALA violations were monitored. Results: From 7/01/02 to 9/30/02, 16,546 patients registered in the emergency department and had average time to vital signs of 12.4 minutes. The number of patients who LWBS was 992 (6.0%), with two EMTALA violations. After the implementation, 41,142 patients registered, with an average time to vital signs of 5.5 minutes. The patients who LWBS decreased to 583 (1.4%), and there was only one EMTALA violation. Recommendations: By implementing a vital-signs booth and a medical screening examination, the percentage of patients who LWBS decreased by 4.6%. Although there was one EMTALA violation after the implementation, the timeframe and the number of patients was approximately triple that of pre-implementation. Therefore, six EMTALA violations may have been anticipated. Emergency departments may want to consider a similar approach to improve efficient care to patients and decrease the numbers of patients who leave prior to receiving a medical screening examination.
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.titleEMTALA and LWBS Populationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163030-
dc.description.abstract<table><tr><td colspan="2" class="item-title">EMTALA and LWBS Population</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">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Steffen, Tammy, RN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Aurora Sinai Medical Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2255 E. Michigan Avenue, Oak Creek, WI, 53154, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(414) 219-3763</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">tammy.steffen@aurora.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jeanne Smrz-DuPont, BSN, RN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this project was to decrease the time from arrival in the emergency department (ED) to initial triage vital signs, thereby decreasing the number of patients who leave the emergency department prior to receiving a medical screening exam, thus lessening exposure to an EMTALA violation. Design: The study was designed as a prospective, interventional comparison. A multidisciplinary team including emergency department, admitting, and information services personnel participated in this study. Setting/subjects: The project was conducted in an urban academic medical center with 64,000 annual ED visits, serving a culturally-diverse population. Methods: Records from all ED visits from 7/01/02 to 09/30/02 were obtained. For patients who had left without being seen (LWBS), the time from arrival to time of initial vital signs calculated. The percentage of the LWBS and the number of EMTALA violations were monitored. From 10/01/02 through 6/30/03, a vital-signs booth was placed at the main triage area with non-physician staff responsible for obtaining initial blood pressure, pulse, respiration, temperature, and pulse oximetry. A nurse practitioner or physician assistant assigned to the triage area performed a medical screening examination on every triage patient in order to determine whether an emergent medical condition existed prior to the patient's decision to leave. Time between arrival and initial vital signs, number of LWBS, and number of EMTALA violations were monitored. Results: From 7/01/02 to 9/30/02, 16,546 patients registered in the emergency department and had average time to vital signs of 12.4 minutes. The number of patients who LWBS was 992 (6.0%), with two EMTALA violations. After the implementation, 41,142 patients registered, with an average time to vital signs of 5.5 minutes. The patients who LWBS decreased to 583 (1.4%), and there was only one EMTALA violation. Recommendations: By implementing a vital-signs booth and a medical screening examination, the percentage of patients who LWBS decreased by 4.6%. Although there was one EMTALA violation after the implementation, the timeframe and the number of patients was approximately triple that of pre-implementation. Therefore, six EMTALA violations may have been anticipated. Emergency departments may want to consider a similar approach to improve efficient care to patients and decrease the numbers of patients who leave prior to receiving a medical screening examination.</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:21Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:21Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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