Abstract

Session B presented Thursday, September 27, 11:30 am-12:30 pm

Purpose: The purpose of this evidence based project was to improve the patient experience by providing direct access to a nurse upon arrival to the emergency department This provides a culture of caring and allowed for a faster throughput process for patients by decreasing the door to triage time to an average of 17 minutes, 3 minutes less than the national benchmark.

Design: The design of this evidence based project was a nurse driven triage process improvement plan to provide more visibility and access to the triage nurse by patients and their family members upon arrival to the emergency department. Setting: This evidence based project for the triage process improvement plan occurred in a suburban 16 bed free standing emergency department.

Participants/Subjects: The participants of this evidence based project for the triage process improvement plan included all patients that presented to the emergency department for triage over a six month time period. Methods: In this triage process improvement plan triage was relocated to a physical space in the emergency department front lobby and waiting area from behind a locked access door. By relocation of triage the nurse was immediately visible to all patients and family members as they entered the emergency department and during their wait time in the lobby. Access to the nurse while patients were waiting to be roomed was identified as a positive factor and promoted a culture of caring for the patients served in the community.

Results/Outcomes: Prior to moving triage to the front lobby and waiting area it was located behind a locked access door. The average door to triage time was 38 minutes in 2015 and 28.5 minutes through September of 2016. At the start of this triage process change in October 2016 there was an immediate decrease in door to triage time to 17 minutes. This trend continued during the 6 months of data collection with the average door to triage time staying at 17.33 minutes. The unit goal in 2016 was door to triage in 20 minutes of less. Our emergency department stretched the goal in 2017 to a door to triage in 15 minutes or less. At the time of final data collection the average continued to trend down to 16.4 minutes by the end of August 2017. Implications: The triage process improvement plan was successful. By relocating the physical space of triage to a visible area to patients and their families the triage nurse was able to provide better quality initiation of care and throughput of patients by decreasing the amount of time waiting to be seen by a healthcare provider. This was viewed positively by patients as seen in their overall patient satisfaction scores obtained by Press-Ganey. With faster door to triage times patients were able to have their overall length of stay decreased as well as a significant reduction in patients that left without being seen. The triage nurse was portrayed as more caring and compassionate since they were available beyond triage as the patients waited to be roomed.

Author Details

Katharine McLary, BSN, RN

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Throughput, Patient-centered, Triage

Conference Name

Emergency Nursing 2018

Conference Host

Emergency Nurses Association

Conference Location

Pittsburgh, Pennsylvania, USA

Conference Year

2018

Rights Holder

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Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Patient centered triage process change to improve throughput in a freestanding emergency department

Pittsburgh, Pennsylvania, USA

Session B presented Thursday, September 27, 11:30 am-12:30 pm

Purpose: The purpose of this evidence based project was to improve the patient experience by providing direct access to a nurse upon arrival to the emergency department This provides a culture of caring and allowed for a faster throughput process for patients by decreasing the door to triage time to an average of 17 minutes, 3 minutes less than the national benchmark.

Design: The design of this evidence based project was a nurse driven triage process improvement plan to provide more visibility and access to the triage nurse by patients and their family members upon arrival to the emergency department. Setting: This evidence based project for the triage process improvement plan occurred in a suburban 16 bed free standing emergency department.

Participants/Subjects: The participants of this evidence based project for the triage process improvement plan included all patients that presented to the emergency department for triage over a six month time period. Methods: In this triage process improvement plan triage was relocated to a physical space in the emergency department front lobby and waiting area from behind a locked access door. By relocation of triage the nurse was immediately visible to all patients and family members as they entered the emergency department and during their wait time in the lobby. Access to the nurse while patients were waiting to be roomed was identified as a positive factor and promoted a culture of caring for the patients served in the community.

Results/Outcomes: Prior to moving triage to the front lobby and waiting area it was located behind a locked access door. The average door to triage time was 38 minutes in 2015 and 28.5 minutes through September of 2016. At the start of this triage process change in October 2016 there was an immediate decrease in door to triage time to 17 minutes. This trend continued during the 6 months of data collection with the average door to triage time staying at 17.33 minutes. The unit goal in 2016 was door to triage in 20 minutes of less. Our emergency department stretched the goal in 2017 to a door to triage in 15 minutes or less. At the time of final data collection the average continued to trend down to 16.4 minutes by the end of August 2017. Implications: The triage process improvement plan was successful. By relocating the physical space of triage to a visible area to patients and their families the triage nurse was able to provide better quality initiation of care and throughput of patients by decreasing the amount of time waiting to be seen by a healthcare provider. This was viewed positively by patients as seen in their overall patient satisfaction scores obtained by Press-Ganey. With faster door to triage times patients were able to have their overall length of stay decreased as well as a significant reduction in patients that left without being seen. The triage nurse was portrayed as more caring and compassionate since they were available beyond triage as the patients waited to be roomed.