Improving Throughput for Patients Admitted From the Emergency Department: Implementation of a Standardized Report Process. Issue 4 (October 2020)

• Record Type: Journal Article
• Authors: Wolak, Eric; Jones, Cheryl; Leeman, Jennifer; Madigan, Catherine
• Is Part Of: Journal of nursing care quality. Volume 35:Issue 4(2020)
• Publication Date: 2020-10
• Subjects: emergency department -- handoff -- Lean methodology -- standardized handoff report -- throughput; Nursing -- Standards -- Periodicals; Nursing audit -- Periodicals; Health facilities -- Safety measures -- Periodicals; Nurse administrators -- Periodicals; 610.73
• DOI: 10.1097/NCQ.0000000000000462
• Languages: English
• ISSNs: 1057-3631

Abstract

Abstract : Background: Inefficient emergency department to inpatient handoff processes can contribute to delayed care. Local Problem: The average emergency department length of stay for admitted patients and admission wait times at this institution were well above national averages, and a standard handoff process was lacking. Methods: Lean methodology was used to evaluate flow and identify opportunities for improvement. Interventions: Two tools were developed to standardize handoff. Results: Emergency department length of stay and admission wait times were not significantly improved following intervention implementation. However, patient transfer time decreased significantly ( P < .01, F = 29.02) from 30.5 minutes (SD = 18.2) to 21.7 minutes (SD = 7.4). The length of time to give/receive report also decreased significantly ( P = .04, F = 2.2) from 3.8 (SD = 1.6) minutes to 2.8 (SD = 1.2) minutes. Conclusions: Although length of stay and admission wait times did not decline significantly, implementation of standard work and tools can potentially improve patient flow.