Abstract
Poster presentation
Session H presented Wednesday, October 2, 11:30 am-12:30 pm
Purpose: Patients who leave the emergency department before being seen by a physician, or against medical advice are at high risk for experiencing adverse medical outcomes and financial loss. This project aimed to compare the walkout rates in the emergency department of a 400 bed, acute care facility pre- and post-implementation of a pivot nurse and hospital surge plan.
Design: This was a retrospective analysis of data collected and entered into an administrative database.
Setting: This project took place in the emergency department of a 400 bed, acute care community hospital in Southern California.
Participants/Subjects: All patients who visited the emergency department from January - June 2017 and January - June 2018. This project did not utilize any patient information, charts, or characteristics. Data was gathered retrospectively from the metrics collected in an administrative database.
Methods: Baseline walkout rate data from January - June 2017 was collected retrospectively from the administrative database. The data was analyzed and compared to the national benchmark. A search of the evidence was conducted to identify strategies to decrease patient walkouts from the emergency department. Prior to implementing the use of a pivot nurse and a hospital surge plan, all hospital employees received education and training on both interventions. Drills were conducted for 4 weeks prior to going live and followed by a debriefing session. Post-intervention walkout rate data from January - June 2018 was collected retrospectively from the administrative database. A chi-square test was used to compare the proportion of patient walkouts pre- and post-intervention.
Results/Outcomes: The proportion of patient walkouts decreased significantly from 0.04 pre-intervention (n=1,022/26,494 patient visits) to 0.02 post-intervention (n=570/27,328 patient visits) (p< .00001).
Implications: Strategic planning, engagement and involvement of all organizational key stakeholders in the implementation of a pivot nurse and a hospital surge plan are critical to the success of these interventions and the impact these interventions clearly have on patient walkouts, patient satisfaction, and patient well-being. Leaders must engage the frontline team from the beginning and throughout any process improvement or quality assurance project to ensure continued awareness and team involvement as the frontline team members comprise a great portion of the key stakeholders that will eventually be the primary users of the process. The buy-in and value generated from the engagement and involvement of the frontline team may help with a smooth implementation of new processes that yield improved patient outcomes.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Walkouts, Nursing, Throughput
Recommended Citation
Flaws, Denise; Zambrano, Jenelle M.; Kelly, Christine; and Cirillo, Deana, "Surge plan and pivotal nurse impact on ED walkout rate" (2020). General Submissions: Presenations (Oral and Poster). 109.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/109
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Surge plan and pivotal nurse impact on ED walkout rate
Austin, Texas, USA
Poster presentation
Session H presented Wednesday, October 2, 11:30 am-12:30 pm
Purpose: Patients who leave the emergency department before being seen by a physician, or against medical advice are at high risk for experiencing adverse medical outcomes and financial loss. This project aimed to compare the walkout rates in the emergency department of a 400 bed, acute care facility pre- and post-implementation of a pivot nurse and hospital surge plan.
Design: This was a retrospective analysis of data collected and entered into an administrative database.
Setting: This project took place in the emergency department of a 400 bed, acute care community hospital in Southern California.
Participants/Subjects: All patients who visited the emergency department from January - June 2017 and January - June 2018. This project did not utilize any patient information, charts, or characteristics. Data was gathered retrospectively from the metrics collected in an administrative database.
Methods: Baseline walkout rate data from January - June 2017 was collected retrospectively from the administrative database. The data was analyzed and compared to the national benchmark. A search of the evidence was conducted to identify strategies to decrease patient walkouts from the emergency department. Prior to implementing the use of a pivot nurse and a hospital surge plan, all hospital employees received education and training on both interventions. Drills were conducted for 4 weeks prior to going live and followed by a debriefing session. Post-intervention walkout rate data from January - June 2018 was collected retrospectively from the administrative database. A chi-square test was used to compare the proportion of patient walkouts pre- and post-intervention.
Results/Outcomes: The proportion of patient walkouts decreased significantly from 0.04 pre-intervention (n=1,022/26,494 patient visits) to 0.02 post-intervention (n=570/27,328 patient visits) (p< .00001).
Implications: Strategic planning, engagement and involvement of all organizational key stakeholders in the implementation of a pivot nurse and a hospital surge plan are critical to the success of these interventions and the impact these interventions clearly have on patient walkouts, patient satisfaction, and patient well-being. Leaders must engage the frontline team from the beginning and throughout any process improvement or quality assurance project to ensure continued awareness and team involvement as the frontline team members comprise a great portion of the key stakeholders that will eventually be the primary users of the process. The buy-in and value generated from the engagement and involvement of the frontline team may help with a smooth implementation of new processes that yield improved patient outcomes.