What’s The Rush? Reducing Ambulance Hand-Off Time and Increasing Patient Safety

2.50
Hdl Handle:
http://hdl.handle.net/10755/306614
Category:
Abstract
Type:
Poster
Title:
What’s The Rush? Reducing Ambulance Hand-Off Time and Increasing Patient Safety
Author(s):
Liebzeit, Christina; Shively, Margaret
Lead Author STTI Affiliation:
Non-member
Author Details:
Christina Liebzeit, RN, christina.liebzeit@stjohn.org; Margaret Shively, RN, CNM
Abstract:

Evidence-based Practice Abstract

Purpose: A recent closure of a nearby hospital and their emergency room resulted in a 35% increase in walk-in patient volume, and a 50% increase in ambulance traffic to our facility. The purpose of this project was to improve the safety of the patients that arrived via ambulance by identifying solutions that could streamline ambulance and patient placement, and provide immediate patient assessment. Our goal was also to improve ambulance/paramedic turnaround time within our facility to ensure timely hand-off and ability for the ambulance personnel to return to the community.

Design: A multidisciplinary staff lead team was assembled to work on this quality assurance project.

Setting: Our facility is a 365 bed urban hospital with a 47 bed emergency room. We are a teaching facility with 75,000 ED visits annually that serves 5 surrounding communities.

Participants/Subjects: Participants in this project included a multi-disciplinary team consisting of emergency room nurses, physicians, and techs. Members of the surrounding community emergency medical services were also included as members of this team.

Methods: The team used root cause analysis to identify barriers and then created feasible plans to make their improvements. PDCA (plan, do, check, act) cycles and feedback loops from paramedic and nursing personnel were used to evaluate the interventions.

Results/outcomes: The goal was to maintain a door to triage/RN assessment time of 5 minutes according to the ENA standard of care despite our significant increase in patient population. Previous time studies on door to triage were 7 minutes for our facility. Subsequent to other hospital closing door to triage was 12 minutes. Post- EMS intervention times were 8 minutes. Feedback loop from EMS services stated an increased satisfaction with hand-off and turnaround times. Emergency room nurses noted a greater sense of patient safety knowing that the patient was immediately assessed and triaged.

Implications: The data reflects improved throughput measures for EMS and ambulatory patients entering our Emergency Department. The utilization of 1 RN and 1 ER tech as a frontline team assigned to the triage of EMS patients was found to be a successful intervention. This process has ensured that ambulances and paramedics can reenter the community in a more timely fashion. This successful quality assurance project can be used a framework for other facilities across the country experiencing increased volume due to hospital closures in their region.

Changes to our facilities protocols at handling EMS throughput/satisfaction and patient safety were addressed. By utilizing space adjacent to EMS entrance to receive all ambulance traffic streamlined our throughput efforts. Utilization of 1 RN and 1 ER tech in this space has ensured a timely triage and assessment of all patients entering our facility by ambulance.

Keywords:
Increasing safety of patients arriving by ambulance
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and 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.titleWhat’s The Rush? Reducing Ambulance Hand-Off Time and Increasing Patient Safetyen_GB
dc.contributor.authorLiebzeit, Christinaen_GB
dc.contributor.authorShively, Margareten_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsChristina Liebzeit, RN, christina.liebzeit@stjohn.org; Margaret Shively, RN, CNMen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306614-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: A recent closure of a nearby hospital and their emergency room resulted in a 35% increase in walk-in patient volume, and a 50% increase in ambulance traffic to our facility. The purpose of this project was to improve the safety of the patients that arrived via ambulance by identifying solutions that could streamline ambulance and patient placement, and provide immediate patient assessment. Our goal was also to improve ambulance/paramedic turnaround time within our facility to ensure timely hand-off and ability for the ambulance personnel to return to the community.</p><p>Design: A multidisciplinary staff lead team was assembled to work on this quality assurance project.</p><p>Setting: Our facility is a 365 bed urban hospital with a 47 bed emergency room. We are a teaching facility with 75,000 ED visits annually that serves 5 surrounding communities.</p><p>Participants/Subjects: Participants in this project included a multi-disciplinary team consisting of emergency room nurses, physicians, and techs. Members of the surrounding community emergency medical services were also included as members of this team.</p><p>Methods: The team used root cause analysis to identify barriers and then created feasible plans to make their improvements. PDCA (plan, do, check, act) cycles and feedback loops from paramedic and nursing personnel were used to evaluate the interventions.</p><p>Results/outcomes: The goal was to maintain a door to triage/RN assessment time of 5 minutes according to the ENA standard of care despite our significant increase in patient population. Previous time studies on door to triage were 7 minutes for our facility. Subsequent to other hospital closing door to triage was 12 minutes. Post- EMS intervention times were 8 minutes. Feedback loop from EMS services stated an increased satisfaction with hand-off and turnaround times. Emergency room nurses noted a greater sense of patient safety knowing that the patient was immediately assessed and triaged.</p><p>Implications: The data reflects improved throughput measures for EMS and ambulatory patients entering our Emergency Department. The utilization of 1 RN and 1 ER tech as a frontline team assigned to the triage of EMS patients was found to be a successful intervention. This process has ensured that ambulances and paramedics can reenter the community in a more timely fashion. This successful quality assurance project can be used a framework for other facilities across the country experiencing increased volume due to hospital closures in their region.</p><p>Changes to our facilities protocols at handling EMS throughput/satisfaction and patient safety were addressed. By utilizing space adjacent to EMS entrance to receive all ambulance traffic streamlined our throughput efforts. Utilization of 1 RN and 1 ER tech in this space has ensured a timely triage and assessment of all patients entering our facility by ambulance. </p>en_GB
dc.subjectIncreasing safety of patients arriving by ambulanceen_GB
dc.date.available2013-12-09T17:00:46Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:46Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and 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
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