2.50
Hdl Handle:
http://hdl.handle.net/10755/306547
Category:
Abstract
Type:
Poster
Title:
Moving and Shaking - The Emergency Department Throughput Facilitator
Author(s):
Menafra, Mary; Humphries, Beth; Baker, Kathy
Lead Author STTI Affiliation:
Non-member
Author Details:
Mary Menafra, MSN, RN, CEN, menafram@gmail.com; Beth Humphries, BSN, RN; Kathy Baker, PhD, RN, NE-BC
Abstract:

Evidence-based Practice Abstract

Purpose: Emergency Department overcrowding is a national crisis, and healthcare facilities are concerned with and seeing an increased trend in the numbers of patients seeking care in the Emergency Department. The ability to improve patient flow is becoming increasingly important. The Academic Level 1 Trauma Center, that was the site for this inquiry, had decreased diversion hours significantly over the past several years but rebounded with higher diversion hours than the national average as their inpatient census reached record highs. Subsequently the Emergency Department length of stay and left without being seen rates also rose to rates higher than the national average. This facility is a safety net hospital and the increasing census is anticipated to continue to rise as the challenges of health care reform evolve, making strategies for improvement of the problem all the more necessary. The objective of this evidence-based project was to determine if the implementation of a budget neutral throughput facilitator, one who has knowledge of the inpatient flow and available bed space through constant visual and phone contact with bed management could improve diversion hours, and lower overall length of stay in the Emergency Department.

Design: The John Hopkins Model for evidence-based practice project implementation was used to guide inquiry for this Emergency Department Throughput model. A comprehensive literature review was done, and comparison of this Emergency Department’s current practice with that of other academic Emergency Departments with similar census.

Setting: The setting for this was an academic urban Level 1 Trauma Center with an annual census of 88,000.

Participants/Subjects: Entire daily census of an urban Level 1 Trauma Center Adult Emergency Department with the utilization of electronic tracking system.

Methods: Direct observation, and active intervention with staff with the inclusion of an RN Flow facilitator during specific hours and days of the week. The design monitored for length of stay in components of time; bed to disposition, disposition to admit, and admit to bed assigned. The flow facilitator actively interacted with staff and physicians to influence these components to effect the decision to implement diversion. The pilot period for this model was four months.

Results/Outcomes: It is believed that the evidence supports the development of a Throughput Facilitator role within the Emergency Department. Diversion hours during the active engagement of this role were down from greater than 200 hours per month prior to the implementation of the project to less than 50 hours per month during the project period.

Implications: The recommendation from the evidence provided by this project is to create a budget neutral position of an Emergency Department Flow Facilitator utilizing current full time equivalents from within the current staff. The model should be expanded to include other duties for this role which may impact the left without being seen rates.

Keywords:
Throughput Facilitator
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Ft. Lauderdale, Florida, USA
Description:
2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleMoving and Shaking - The Emergency Department Throughput Facilitatoren_GB
dc.contributor.authorMenafra, Maryen_GB
dc.contributor.authorHumphries, Bethen_GB
dc.contributor.authorBaker, Kathyen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMary Menafra, MSN, RN, CEN, menafram@gmail.com; Beth Humphries, BSN, RN; Kathy Baker, PhD, RN, NE-BCen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306547-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Emergency Department overcrowding is a national crisis, and healthcare facilities are concerned with and seeing an increased trend in the numbers of patients seeking care in the Emergency Department. The ability to improve patient flow is becoming increasingly important. The Academic Level 1 Trauma Center, that was the site for this inquiry, had decreased diversion hours significantly over the past several years but rebounded with higher diversion hours than the national average as their inpatient census reached record highs. Subsequently the Emergency Department length of stay and left without being seen rates also rose to rates higher than the national average. This facility is a safety net hospital and the increasing census is anticipated to continue to rise as the challenges of health care reform evolve, making strategies for improvement of the problem all the more necessary. The objective of this evidence-based project was to determine if the implementation of a budget neutral throughput facilitator, one who has knowledge of the inpatient flow and available bed space through constant visual and phone contact with bed management could improve diversion hours, and lower overall length of stay in the Emergency Department.</p><p>Design: The John Hopkins Model for evidence-based practice project implementation was used to guide inquiry for this Emergency Department Throughput model. A comprehensive literature review was done, and comparison of this Emergency Department’s current practice with that of other academic Emergency Departments with similar census. </p><p>Setting: The setting for this was an academic urban Level 1 Trauma Center with an annual census of 88,000.</p><p>Participants/Subjects: Entire daily census of an urban Level 1 Trauma Center Adult Emergency Department with the utilization of electronic tracking system.</p><p>Methods: Direct observation, and active intervention with staff with the inclusion of an RN Flow facilitator during specific hours and days of the week. The design monitored for length of stay in components of time; bed to disposition, disposition to admit, and admit to bed assigned. The flow facilitator actively interacted with staff and physicians to influence these components to effect the decision to implement diversion. The pilot period for this model was four months.</p><p>Results/Outcomes: It is believed that the evidence supports the development of a Throughput Facilitator role within the Emergency Department. Diversion hours during the active engagement of this role were down from greater than 200 hours per month prior to the implementation of the project to less than 50 hours per month during the project period.</p><p>Implications: The recommendation from the evidence provided by this project is to create a budget neutral position of an Emergency Department Flow Facilitator utilizing current full time equivalents from within the current staff. The model should be expanded to include other duties for this role which may impact the left without being seen rates.</p>en_GB
dc.subjectThroughput Facilitatoren_GB
dc.date.available2013-12-09T16:59:34Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:34Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationFt. Lauderdale, Florida, USAen_GB
dc.description2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.