12.00
Hdl Handle:
http://hdl.handle.net/10755/344178
Category:
Abstract
Type:
Poster
Title:
Enhanced Emergency Department Discharge Process
Author(s):
Alexander, Danette; Smith, Leah; Robinson, Kenneth; Abbott, Lincoln
Lead Author STTI Affiliation:
Non-member
Author Details:
Danette Alexander, PhD©, MSN, RN, NEA-BC; Leah Smith, MSN, BS, RN; Kenneth Robinson, MD, MHCM; Lincoln Abbott, MD, FACEP
Abstract:
Research Abstract Purpose: Patient flow processes in the ED include input, throughput and output. Output processes occur between the time of the decision to admit or discharge the patient and the time the patient leaves the ED. There are many studies in the literature reporting reducing output times for admitted patients, but there is little describing effective output processes for discharged patients. The objective of this study was to determine whether changes in nurse and provider discharge process can result in a reduction in discharge time. Design: The quality project is a before and after process improvement study. Setting: The project was conducted in an urban, university-affiliated, Level 1 trauma center with a volume of 101,000 patient visits. The study period was 3 months pre and 3 months post intervention. July, August, and September of consecutive years were used to avoid seasonal variation. Participants/Subjects: All providers and nurses working in the emergency department. Methods: All providers were educated to consistently; launch the discharge icon in the EDIS, prepare complete discharge instructions, print the instructions and put the instructions in the patients chart. The nurses were educated to; more frequently watch for the discharge icon in the EDIS, immediately notify provider of incomplete instructions, and ask for assistance from other nurses if they are not able to discharge the patient in a timely manner. The discharge time was defined as time from decision to discharge to time the patient left the ED (both are timestamps in EDIS). Mean daily volume and percent LWBS, as well as, ESI level, discharge time and ALOS for each patient discharged were determined. The results were compared using the Student’s T test. Results/Outcomes: There were 26,515 patients in the pre intervention group and 26,414 patients in the post intervention group. There was no significant change in the mean daily volume (mean pre 288, mean post 287, p >0.05), and ESI level (mean pre 3.09, mean post 3.01, p>0.05). There was a significant change in the discharge time (min) (mean pre 40.6, mean post 29.9, p < 0.05), ALOS (min) (mean pre 313.8, mean post 295.5, p <0.05), and daily LWBS (mean pre 4.0%, mean post 2.74%, p< 0.05). Implications: More efficient nurse and provider discharge processes can result in a reduction in discharge time. In addition, reducing the discharge time may also help to reduce the percent of patients who leave the ED without being seen.
Keywords:
ED Discharge Process
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.titleEnhanced Emergency Department Discharge Processen_GB
dc.contributor.authorAlexander, Danetteen_GB
dc.contributor.authorSmith, Leahen_GB
dc.contributor.authorRobinson, Kennethen_GB
dc.contributor.authorAbbott, Lincolnen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsDanette Alexander, PhD©, MSN, RN, NEA-BC; Leah Smith, MSN, BS, RN; Kenneth Robinson, MD, MHCM; Lincoln Abbott, MD, FACEPen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344178-
dc.description.abstractResearch Abstract Purpose: Patient flow processes in the ED include input, throughput and output. Output processes occur between the time of the decision to admit or discharge the patient and the time the patient leaves the ED. There are many studies in the literature reporting reducing output times for admitted patients, but there is little describing effective output processes for discharged patients. The objective of this study was to determine whether changes in nurse and provider discharge process can result in a reduction in discharge time. Design: The quality project is a before and after process improvement study. Setting: The project was conducted in an urban, university-affiliated, Level 1 trauma center with a volume of 101,000 patient visits. The study period was 3 months pre and 3 months post intervention. July, August, and September of consecutive years were used to avoid seasonal variation. Participants/Subjects: All providers and nurses working in the emergency department. Methods: All providers were educated to consistently; launch the discharge icon in the EDIS, prepare complete discharge instructions, print the instructions and put the instructions in the patients chart. The nurses were educated to; more frequently watch for the discharge icon in the EDIS, immediately notify provider of incomplete instructions, and ask for assistance from other nurses if they are not able to discharge the patient in a timely manner. The discharge time was defined as time from decision to discharge to time the patient left the ED (both are timestamps in EDIS). Mean daily volume and percent LWBS, as well as, ESI level, discharge time and ALOS for each patient discharged were determined. The results were compared using the Student’s T test. Results/Outcomes: There were 26,515 patients in the pre intervention group and 26,414 patients in the post intervention group. There was no significant change in the mean daily volume (mean pre 288, mean post 287, p >0.05), and ESI level (mean pre 3.09, mean post 3.01, p>0.05). There was a significant change in the discharge time (min) (mean pre 40.6, mean post 29.9, p < 0.05), ALOS (min) (mean pre 313.8, mean post 295.5, p <0.05), and daily LWBS (mean pre 4.0%, mean post 2.74%, p< 0.05). Implications: More efficient nurse and provider discharge processes can result in a reduction in discharge time. In addition, reducing the discharge time may also help to reduce the percent of patients who leave the ED without being seen.en_GB
dc.subjectED Discharge Processen_GB
dc.date.available2015-02-04T11:27:53Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:53Z-
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
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.