2.50
Hdl Handle:
http://hdl.handle.net/10755/344165
Category:
Abstract
Type:
Poster
Title:
Changing How People Think to Improve the Patient Experience
Author(s):
Gallaher, Carol; Gauniel, Kathy; Sipes-Eser, Lesa; Dowdle, Jonathan; Devore, Aaron
Lead Author STTI Affiliation:
Non-member
Author Details:
Carol Gallaher, MSN, RN, CEN, cgallaherRN@gmail.com; Kathy Gauniel, BS, AA, RN; Lesa Sipes-Eser, RN; Jonathan Dowdle, PA-C; Aaron Devore, CNA
Abstract:
Evidence-based Practice Abstract Purpose: Patients waiting to be seen by a provider in the Emergency Department are initially sorted by a Quick Look Nurse. This nurse determines if the patient is sick or not sick. “Not sick” patients are assigned an ESI level of 4 or 5. “Not sick” ESI level 4 or 5 patients had the highest left without being seen rates along with the longest waits for Provider Screening, RN assessment, and treatments. The purpose of focusing on caring for the “Not Sick” patient was to improve the patient experience, decrease the door to provider time and decrease the left without being seen rate. Design: This was an evidence based Quality Assurance project initiated by the nursing and a new provider group transitioning into the ED. Setting: The setting is a 276 bed full service teaching hospital with a Level III Trauma ED, seeing 85,000 patients each year. 94% of those patients fit into the “not sick” criteria. Participants/Subjects: The participants in the study were ED patients who met the “not sick” criteria, most of which would have been assigned and ESI score of 4 or 5. The healthcare team consisted of Nurses, ED Technician, Physician Assistant, Doctor, Registration, Phlebotomy, Diagnostic Imaging and Security. Methods: The Appreciative Inquiry model was used to facilitate the changes in care. This method focuses on five principles: constructionist, simultaneity, poetic, anticipatory, and positive. Beginning with team input on the current care of the “not sick” patients the team used the “how we know” and “what we do relationship”. The team was then guided into inquiry. The principle of simultaneity is as we inquire into systems we change them (Bushe & Kassam, 2005). Through the use of storytelling about current patient experiences, images of a future state developed. The team committed to changes in care for the not sick patient by keeping them in a chair during their stay instead of on a stretcher. This change required nursing and physician alignment, registration relocation, phlebotomy resources, equipment relocation, and a new mental model with the focus on the patient experience. Results/Outcomes: The change implemented in July of 2013 has increased patient satisfaction for total time spent from 26.2 to 74.6, decreased door to provider times by 7 minutes, reduced total time to discharge 13 minutes, and improved turnaround time for admitted patients by 56 minutes. Left without being seen rates decreased from 6% to 1.8%. Implications: Using the Appreciative Inquiry Model to facilitate change in the ED allowed for a sustained practice change. The staff and provider team designed the solutions associated with the change. The members of the team worked daily in the area where the patients were cared for, living the changes daily. Encouraging this team to design the new process, and meet regularly to evolve the process was supported by the ED nursing and Medical leadership allowing for an improved and sustained outcome.
Keywords:
Improving Patient Experience; Patient Experience
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.titleChanging How People Think to Improve the Patient Experienceen_GB
dc.contributor.authorGallaher, Carolen_GB
dc.contributor.authorGauniel, Kathyen_GB
dc.contributor.authorSipes-Eser, Lesaen_GB
dc.contributor.authorDowdle, Jonathanen_GB
dc.contributor.authorDevore, Aaronen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsCarol Gallaher, MSN, RN, CEN, cgallaherRN@gmail.com; Kathy Gauniel, BS, AA, RN; Lesa Sipes-Eser, RN; Jonathan Dowdle, PA-C; Aaron Devore, CNAen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344165-
dc.description.abstractEvidence-based Practice Abstract Purpose: Patients waiting to be seen by a provider in the Emergency Department are initially sorted by a Quick Look Nurse. This nurse determines if the patient is sick or not sick. “Not sick” patients are assigned an ESI level of 4 or 5. “Not sick” ESI level 4 or 5 patients had the highest left without being seen rates along with the longest waits for Provider Screening, RN assessment, and treatments. The purpose of focusing on caring for the “Not Sick” patient was to improve the patient experience, decrease the door to provider time and decrease the left without being seen rate. Design: This was an evidence based Quality Assurance project initiated by the nursing and a new provider group transitioning into the ED. Setting: The setting is a 276 bed full service teaching hospital with a Level III Trauma ED, seeing 85,000 patients each year. 94% of those patients fit into the “not sick” criteria. Participants/Subjects: The participants in the study were ED patients who met the “not sick” criteria, most of which would have been assigned and ESI score of 4 or 5. The healthcare team consisted of Nurses, ED Technician, Physician Assistant, Doctor, Registration, Phlebotomy, Diagnostic Imaging and Security. Methods: The Appreciative Inquiry model was used to facilitate the changes in care. This method focuses on five principles: constructionist, simultaneity, poetic, anticipatory, and positive. Beginning with team input on the current care of the “not sick” patients the team used the “how we know” and “what we do relationship”. The team was then guided into inquiry. The principle of simultaneity is as we inquire into systems we change them (Bushe & Kassam, 2005). Through the use of storytelling about current patient experiences, images of a future state developed. The team committed to changes in care for the not sick patient by keeping them in a chair during their stay instead of on a stretcher. This change required nursing and physician alignment, registration relocation, phlebotomy resources, equipment relocation, and a new mental model with the focus on the patient experience. Results/Outcomes: The change implemented in July of 2013 has increased patient satisfaction for total time spent from 26.2 to 74.6, decreased door to provider times by 7 minutes, reduced total time to discharge 13 minutes, and improved turnaround time for admitted patients by 56 minutes. Left without being seen rates decreased from 6% to 1.8%. Implications: Using the Appreciative Inquiry Model to facilitate change in the ED allowed for a sustained practice change. The staff and provider team designed the solutions associated with the change. The members of the team worked daily in the area where the patients were cared for, living the changes daily. Encouraging this team to design the new process, and meet regularly to evolve the process was supported by the ED nursing and Medical leadership allowing for an improved and sustained outcome.en_GB
dc.subjectImproving Patient Experienceen_GB
dc.subjectPatient Experienceen_GB
dc.date.available2015-02-04T11:27:39Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:39Z-
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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