Abstract
Poster presentation
Session C presented Monday, September 30, 1:00-2:00 pm
Purpose: The Emergency Department (ED) staff and providers identified a need to change processes as the leaving before evaluation (LBE) rate was climbing. Turnaround time metrics were not meeting hospital standards.
Design: A quality improvement team was formed to develop “A Better Way.†Using this model, the multi-disciplinary team developed a Triage Direct to Bed process.
Setting: The setting was a rural, acute care, nonprofit, teaching hospital in Southern Ohio. The hospital has 242 beds and the ED has 33 beds with an annual census of 42,000 patient visits.
Participants/Subjects: The participants included ED RNs, LPNs, ED technicians, ED Unit Clerks, ED patient representatives, Clinical Coordinator (Educator), nursing manager, nursing director, ED registration, and ED providers. The team also added ad hoc members for laboratory and medical imaging.
Methods: The method used was “A Better Way†which is similar to FOCUS-PDCA. The team identified the problem, brainstormed ideas and barriers, multi-voted and developed task lists. The team agreed to meet every two weeks. The team agreed to break the ED FLOW into three components: Triage, Middle or Main ED, and Discharge/Transfer/Admission. Using pre-shift briefings and staff huddles, the ED staff were aware of the process changes and goals. Provider support and leadership was critical.
Results/Outcomes: Both nursing staff, provider and patient feedback was positive from the change. Patients remarked how quickly care was started. Staff and providers commented on less patients in the lobby and the monthly LBE rate decreased by 58% in 60 days. The overall turnaround time decreased from 4.1 to 3.8 hours. The final results will be completed by the ENA Conference in 2019.
Implications: ED Staff understand the sense of urgency in their daily work. Building on that premise, the opportunity to identify staff champions to support change was important. Implications for practice include the direct to bed process in the ED setting. Drawing a diagram of the new process was a helpful tool for staff to understand the overall goal. Frequent team meetings gave momentum to the change and sharing the data.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Emergency Nursing, Triage, ED Flow
Recommended Citation
Skaggs, Mary Kate Dilts and Hodge, Angela J., "Triage under construction: Direct to bed process" (2020). General Submissions: Presenations (Oral and Poster). 98.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/98
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
Rights Holder
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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Triage under construction: Direct to bed process
Austin, Texas, USA
Poster presentation
Session C presented Monday, September 30, 1:00-2:00 pm
Purpose: The Emergency Department (ED) staff and providers identified a need to change processes as the leaving before evaluation (LBE) rate was climbing. Turnaround time metrics were not meeting hospital standards.
Design: A quality improvement team was formed to develop “A Better Way.†Using this model, the multi-disciplinary team developed a Triage Direct to Bed process.
Setting: The setting was a rural, acute care, nonprofit, teaching hospital in Southern Ohio. The hospital has 242 beds and the ED has 33 beds with an annual census of 42,000 patient visits.
Participants/Subjects: The participants included ED RNs, LPNs, ED technicians, ED Unit Clerks, ED patient representatives, Clinical Coordinator (Educator), nursing manager, nursing director, ED registration, and ED providers. The team also added ad hoc members for laboratory and medical imaging.
Methods: The method used was “A Better Way†which is similar to FOCUS-PDCA. The team identified the problem, brainstormed ideas and barriers, multi-voted and developed task lists. The team agreed to meet every two weeks. The team agreed to break the ED FLOW into three components: Triage, Middle or Main ED, and Discharge/Transfer/Admission. Using pre-shift briefings and staff huddles, the ED staff were aware of the process changes and goals. Provider support and leadership was critical.
Results/Outcomes: Both nursing staff, provider and patient feedback was positive from the change. Patients remarked how quickly care was started. Staff and providers commented on less patients in the lobby and the monthly LBE rate decreased by 58% in 60 days. The overall turnaround time decreased from 4.1 to 3.8 hours. The final results will be completed by the ENA Conference in 2019.
Implications: ED Staff understand the sense of urgency in their daily work. Building on that premise, the opportunity to identify staff champions to support change was important. Implications for practice include the direct to bed process in the ED setting. Drawing a diagram of the new process was a helpful tool for staff to understand the overall goal. Frequent team meetings gave momentum to the change and sharing the data.