14.33
Hdl Handle:
http://hdl.handle.net/10755/344137
Category:
Abstract
Type:
Poster
Title:
Triage Patient Flow Redesign in an Urban Academic Emergency Department
Author(s):
Gonzaga-Reardon, Marites; Altman, Patricia; Valentine, Runay; Serafin, Frederick
Lead Author STTI Affiliation:
Non-member
Author Details:
Marites Gonzaga-Reardon, MSN, APN, CEN, CCNS-BC, marites_b_gonzaga-reardon@rush.edu; Patricia Altman, MSN, RN, CEN; Runay Valentine, MHA, BSN, RN, CEN, NEA-BC; Frederick Serafin, MBA, BSN, RN, CEN
Abstract:
Evidence-based Practice Abstract Purpose: The purpose of this process improvement project is to evaluate whether the implementation of “Lean approach” interventions in the triage redesign of an urban academic emergency department improves outcome measures (ED metrics: Left without Being Seen (LWBS), length of stay (LOS), patient satisfaction) and patient experience. This project aims to provide insights on the process improvement interventions implemented to address issues of increased length of stay, increased LWBS and decreased patient satisfaction scores after opening of a new 60 bed ED in an urban academic medical center in January 2012. Design: This evidence based project is a quality improvement process redesign of the triage patient flow using the “Lean process approach” process improvement methodology. Setting: The study site is a 60 bed urban comprehensive academic ED in Chicago serving an average of 65,000 patients a year. Participants/Subjects: The study population consists of all emergency department (ED) patients’ visits to the ED from January 2012 to December 2013. Methods: Methods: De-identified data from electronic medical record (EMR) and administrative and clinical data were accessed. Comparisons were made between the 12 months before (January 2012 to November 2012) and 12 months after (from December 2012 to December 2013) implementation of the changes/processes. The triage redesign and rapid improvement process was implemented utilizing the “Lean approach” process improvement methodology through process mapping with ED leadership and staff of ED throughput by identifying patients likely to be discharged from the ED and those likely to be admitted. Data were also obtained from Press Ganey Scores in relation to patient satisfaction. Results/Outcomes: Following process mapping by staff and ED leadership using “Lean approach” methodology, patient flow in triage pod was restructured concentrating on patients likely to be discharged (those with Emergency Severity Index (ESI) level 4 and 5). Interventions implemented by streaming and directing patients to different care areas in the ED have shown improvement in LWBS and length of stay of patients predicted to be discharged. Average length of stay of patients’ awaiting inpatient beds stayed similarly the same. Patient experience as shown in Press Ganey Patient Satisfaction score improved slightly. Implications: Implications: The use of “Lean approach” process improvement methodology offers improvement opportunities in the emergency department and has shown favorable effects especially with streaming of patients into groups by altering practices in relation to the function of Emergency Severity Index triage scale to improve patient flow and throughput. Further studies are recommended in understanding of”Lean approach” effects in relation to patient safety and quality outcomes and on staff satisfaction.
Keywords:
Triage Redesign; Triage Patient Flow
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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.typePosteren_GB
dc.titleTriage Patient Flow Redesign in an Urban Academic Emergency Departmenten_GB
dc.contributor.authorGonzaga-Reardon, Maritesen_GB
dc.contributor.authorAltman, Patriciaen_GB
dc.contributor.authorValentine, Runayen_GB
dc.contributor.authorSerafin, Fredericken_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMarites Gonzaga-Reardon, MSN, APN, CEN, CCNS-BC, marites_b_gonzaga-reardon@rush.edu; Patricia Altman, MSN, RN, CEN; Runay Valentine, MHA, BSN, RN, CEN, NEA-BC; Frederick Serafin, MBA, BSN, RN, CENen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344137-
dc.description.abstractEvidence-based Practice Abstract Purpose: The purpose of this process improvement project is to evaluate whether the implementation of “Lean approach” interventions in the triage redesign of an urban academic emergency department improves outcome measures (ED metrics: Left without Being Seen (LWBS), length of stay (LOS), patient satisfaction) and patient experience. This project aims to provide insights on the process improvement interventions implemented to address issues of increased length of stay, increased LWBS and decreased patient satisfaction scores after opening of a new 60 bed ED in an urban academic medical center in January 2012. Design: This evidence based project is a quality improvement process redesign of the triage patient flow using the “Lean process approach” process improvement methodology. Setting: The study site is a 60 bed urban comprehensive academic ED in Chicago serving an average of 65,000 patients a year. Participants/Subjects: The study population consists of all emergency department (ED) patients’ visits to the ED from January 2012 to December 2013. Methods: Methods: De-identified data from electronic medical record (EMR) and administrative and clinical data were accessed. Comparisons were made between the 12 months before (January 2012 to November 2012) and 12 months after (from December 2012 to December 2013) implementation of the changes/processes. The triage redesign and rapid improvement process was implemented utilizing the “Lean approach” process improvement methodology through process mapping with ED leadership and staff of ED throughput by identifying patients likely to be discharged from the ED and those likely to be admitted. Data were also obtained from Press Ganey Scores in relation to patient satisfaction. Results/Outcomes: Following process mapping by staff and ED leadership using “Lean approach” methodology, patient flow in triage pod was restructured concentrating on patients likely to be discharged (those with Emergency Severity Index (ESI) level 4 and 5). Interventions implemented by streaming and directing patients to different care areas in the ED have shown improvement in LWBS and length of stay of patients predicted to be discharged. Average length of stay of patients’ awaiting inpatient beds stayed similarly the same. Patient experience as shown in Press Ganey Patient Satisfaction score improved slightly. Implications: Implications: The use of “Lean approach” process improvement methodology offers improvement opportunities in the emergency department and has shown favorable effects especially with streaming of patients into groups by altering practices in relation to the function of Emergency Severity Index triage scale to improve patient flow and throughput. Further studies are recommended in understanding of”Lean approach” effects in relation to patient safety and quality outcomes and on staff satisfaction.en_GB
dc.subjectTriage Redesignen_GB
dc.subjectTriage Patient Flowen_GB
dc.date.available2015-02-04T11:27:09Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:09Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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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