2.50
Hdl Handle:
http://hdl.handle.net/10755/163037
Type:
Presentation
Title:
Spotlight: ED Overcrowding and Inpatient Holds-The Contingency Plan
Abstract:
Spotlight: ED Overcrowding and Inpatient Holds-The Contingency Plan
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Presley, Diane, RN, MSN
Contact Address:9000 LaSiesta Bend, Austin, TX, 78749, USA
Contact Telephone:(512) 922-3125
Co-Authors:Gail Robinson, RN, CEN
Purpose: Many factors lead to emergency department (ED) overcrowding and may reduce the emergency department's ability to provide quality patient care. More than 5,000 emergency departments in the United States provide a "safety net" for individuals without access to primary care providers or clinics. The aging population, nursing and physician shortages, rising numbers of uninsured patients, disappearing community resources for chronic substance abuse and psychiatric patients, and holding admitted patients who are waiting for inpatient beds, contribute to ED overcrowding. In addition, emergency departments are expected to be prepared to manage disasters, yet are already taxed for resources. The purpose of this project was to create a contingency plan for managing bed saturation so essential patient care is not delayed. Setting: The setting for this management project was a Level II emergency department with inpatient units in a major tertiary-care hospital. Method: A restructuring of communication for better allocation of resources was developed in a joint effort between the emergency department and inpatient units. The focus was to define bed saturation on all units and declare a triage crisis-level status on admitted patients holding in the emergency department. A tiered protocol was developed to define saturation: 1) Green - routine capacity; 2) Yellow - awareness capacity; and 3) Red - triage crisis. As part of this system, twice-daily bed meetings, a fax report from the emergency department, housekeeping turn-around tracking for ready-bed status, crisis float nurse for ED overflow, and case-management focus for inpatient discharge appointments were implemented. Results: The following results were observed after the contingency plan was implemented: 1) Increased ED throughput; 2) Decreased length of stay for admitted ED patients from an average of 8 hours to 4 hours; 3) Decreased time by 30 minutes of patient placement to unit bed after report called; 4) Increased patient, physician, and staff satisfaction; 5) Increased communication with emergency department and inpatient units; 6) Improved patient care system; and 7) Compliance with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard on ED overcrowding. Recommendations: Implementation of the contingency plan resulted in improved management of bed saturation and the emergency department's patient care system. Key factors for successful implementation include building strong management and unit/team communication, creating tracking-tool strategies that provide accountability for all units, and utilizing inpatient "crisis nurse" float for admitted ED patients.
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.titleSpotlight: ED Overcrowding and Inpatient Holds-The Contingency Planen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163037-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Spotlight: ED Overcrowding and Inpatient Holds-The Contingency 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">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Presley, Diane, RN, MSN</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">9000 LaSiesta Bend, Austin, TX, 78749, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(512) 922-3125</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">predia608@skmc.gov.ae</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Gail Robinson, RN, CEN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Many factors lead to emergency department (ED) overcrowding and may reduce the emergency department's ability to provide quality patient care. More than 5,000 emergency departments in the United States provide a &quot;safety net&quot; for individuals without access to primary care providers or clinics. The aging population, nursing and physician shortages, rising numbers of uninsured patients, disappearing community resources for chronic substance abuse and psychiatric patients, and holding admitted patients who are waiting for inpatient beds, contribute to ED overcrowding. In addition, emergency departments are expected to be prepared to manage disasters, yet are already taxed for resources. The purpose of this project was to create a contingency plan for managing bed saturation so essential patient care is not delayed. Setting: The setting for this management project was a Level II emergency department with inpatient units in a major tertiary-care hospital. Method: A restructuring of communication for better allocation of resources was developed in a joint effort between the emergency department and inpatient units. The focus was to define bed saturation on all units and declare a triage crisis-level status on admitted patients holding in the emergency department. A tiered protocol was developed to define saturation: 1) Green - routine capacity; 2) Yellow - awareness capacity; and 3) Red - triage crisis. As part of this system, twice-daily bed meetings, a fax report from the emergency department, housekeeping turn-around tracking for ready-bed status, crisis float nurse for ED overflow, and case-management focus for inpatient discharge appointments were implemented. Results: The following results were observed after the contingency plan was implemented: 1) Increased ED throughput; 2) Decreased length of stay for admitted ED patients from an average of 8 hours to 4 hours; 3) Decreased time by 30 minutes of patient placement to unit bed after report called; 4) Increased patient, physician, and staff satisfaction; 5) Increased communication with emergency department and inpatient units; 6) Improved patient care system; and 7) Compliance with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard on ED overcrowding. Recommendations: Implementation of the contingency plan resulted in improved management of bed saturation and the emergency department's patient care system. Key factors for successful implementation include building strong management and unit/team communication, creating tracking-tool strategies that provide accountability for all units, and utilizing inpatient &quot;crisis nurse&quot; float for admitted ED patients.</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:28Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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