2.50
Hdl Handle:
http://hdl.handle.net/10755/324150
Category:
Abstract
Type:
Presentation
Title:
Pivoting Triage Out of the Way
Author(s):
Weckman, Suzanne; Riley, Shari D.; Raetz, Mindy
Author Details:
Suzanne Weckman, BSN, RN, CEN, email: sweckman@pcrmc.com; Shari D. Riley, MSN, RN; Mindy Raetz, BSN, RN
Abstract:
Evidence-based Practice Abstract Purpose: Traditional triage is a linear process that proved to be dysfunctional, leading to overcrowding with negative patient satisfaction and ED inefficiency. The purpose of this triage process redesign to parallel processes was to improve operational efficiency by: streamlining patient flow; decreasing throughput time; eliminating or significantly reducing the number of patients leaving before medical screening; improving patient, provider and employee satisfaction; and overall improving delivery of care. Design: A performance improvement project utilizing lean principles that delivers value from beginning to end based on the expressed need of the patient. Setting: A rural community hospital with 38,000 annual emergency department visits. Participants: The redesign process was developed and implemented by a comprehensive team of ED nursing staff, ED leadership, Lab, Radiology, Information Technology, ED physician contract group, pharmacy, registration, housekeeping, decision support. Method: Literature was reviewed for best practice in the area of patient throughput. The redesign team utilized lean methodology to create the desired patient flow, physician zoning, ESI training, 5S methodology, and exclusion criteria for patients seen by Mid-Level Providers. ED staff received education regarding the new process changes. ED leadership presence was increased during implementation of the new process to assist with flow. A pilot was developed for parallel processes, traditional triage model changed to pivot process. Outcome: Utilizing a new pivot process in place of traditional triage led to decreased door to provider times from average of 38 minutes to 26 minutes, decreased total length of stay from average of 191 minutes to 171 minutes, decreased left before medical screening from average of 1.72% to 1.01% and increased patient satisfaction mean score from 87.4 to 89.7. Implications: With the improvement of patient flow through parallel processes patients spend less time at the front end of the ED, minimizing the time to provider evaluation which decreases the overall length of stay. In a time when ED overcrowding is rampant this redesign can assist with patient throughput as well patient and staff satisfaction.
Keywords:
Triage Process Redesign
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix 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. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titlePivoting Triage Out of the Wayen_GB
dc.contributor.authorWeckman, Suzanneen_GB
dc.contributor.authorRiley, Shari D.en_GB
dc.contributor.authorRaetz, Mindyen_GB
dc.author.detailsSuzanne Weckman, BSN, RN, CEN, email: sweckman@pcrmc.com; Shari D. Riley, MSN, RN; Mindy Raetz, BSN, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324150-
dc.description.abstractEvidence-based Practice Abstract Purpose: Traditional triage is a linear process that proved to be dysfunctional, leading to overcrowding with negative patient satisfaction and ED inefficiency. The purpose of this triage process redesign to parallel processes was to improve operational efficiency by: streamlining patient flow; decreasing throughput time; eliminating or significantly reducing the number of patients leaving before medical screening; improving patient, provider and employee satisfaction; and overall improving delivery of care. Design: A performance improvement project utilizing lean principles that delivers value from beginning to end based on the expressed need of the patient. Setting: A rural community hospital with 38,000 annual emergency department visits. Participants: The redesign process was developed and implemented by a comprehensive team of ED nursing staff, ED leadership, Lab, Radiology, Information Technology, ED physician contract group, pharmacy, registration, housekeeping, decision support. Method: Literature was reviewed for best practice in the area of patient throughput. The redesign team utilized lean methodology to create the desired patient flow, physician zoning, ESI training, 5S methodology, and exclusion criteria for patients seen by Mid-Level Providers. ED staff received education regarding the new process changes. ED leadership presence was increased during implementation of the new process to assist with flow. A pilot was developed for parallel processes, traditional triage model changed to pivot process. Outcome: Utilizing a new pivot process in place of traditional triage led to decreased door to provider times from average of 38 minutes to 26 minutes, decreased total length of stay from average of 191 minutes to 171 minutes, decreased left before medical screening from average of 1.72% to 1.01% and increased patient satisfaction mean score from 87.4 to 89.7. Implications: With the improvement of patient flow through parallel processes patients spend less time at the front end of the ED, minimizing the time to provider evaluation which decreases the overall length of stay. In a time when ED overcrowding is rampant this redesign can assist with patient throughput as well patient and staff satisfaction.en_GB
dc.subjectTriage Process Redesignen_GB
dc.date.available2014-08-04T13:28:25Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:25Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix 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. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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