Abstract
Problem
Emergency department nurses are faced with an overwhelming number of patients each
day. The average number of emergency department visits is increasing by 3.5% per year.
Numerous studies have been conducted to improve the patient throughput process, which
has impact on patient flow. A disruption of the process can cause a backlog of patients
and create a hardship for both patients and staff.
Methods
The Plan-Do-Study-Act (PDSA) cycle was used as a specific improvement methodology
for improving patient throughput and served as a component for the Model for Improvement
approach. The article presents a quality improvement initiative created and implemented
to improve patient flow by adding a flow nurse coordinator. The flow nurse coordinator
was proposed to improve patient throughput by expediting and facilitating transport
of the admitted patient to an inpatient bed.
Results
The average time from notification of bed assignment to patient arrival to an inpatient
bed was 104 minutes, almost twice the proposed benchmark and more than the regional
average. The results of the quality initiative changed patient arrival to inpatient
bed from 104 minutes to 84 minutes, a decrease of 20%.
Discussion
The quality initiative team made several recommendations based on the research of
a flow nurse coordinator. The recommendations included a weekly ED staffing committee
meeting, consisting of frontline ED staff, nurse educators, ED leadership, and flow
nurse coordinator. The support and active involvement of the executive leadership
team would assist in sustaining changes to the new process.
Contribution to Emergency Nursing Practice
- •The current state of scientific knowledge on emergency department overcrowding indicates a need to improve patient throughput.
- •The main finding of this research is to improve patient throughput, improve patient and staff satisfaction, and improve patient outcomes.
- •Key implications for emergency nursing practice from this research are to decrease the risk for medical errors, missed and delayed treatments.
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Biography
Ray DeAnda is Nurse Manager at Texas Health Resources, Fort Worth, TX.
Article info
Publication history
Published online: June 20, 2018
Footnotes
Earn Up to 7.5 CE Hours. See page 686.
Identification
Copyright
© 2018 Published by Elsevier Inc. on behalf of Emergency Nurses Association.
