Retrieving a Reputation: A Story of an ED Turnaround
Becky Montesino, RN, BSN, MS, firstname.lastname@example.org
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Design: This was a collaborative, realistic goal setting effort. That would have reliable measures, accountability of its team members.
Setting: This ongoing project is being carried out at a level 2 suburban community hospital in the Deep South.
Participants: All staff and physicians within the adult ED.
Methods: The Press Ganey surveys were used. Data was compared to other hospitals with similar volume. Studer rounding tools; staff engagement; physician partnership and research data are among the methods used for overall improvement. Outcomes are evaluated using Length Of Stay (LOS), Left Without Being Seen (LWBS) and patients leaving Against Medical Advice, (AMA); data is collected monthly.
Results: Data was measured from June 2008 to June 2009. In June 2008 Visits were 4,679 compared to 6,200 in June 09. LWBS was 5.1% compared to 2.0% in June ô09. AMA was 0.7% in June 08 vs 0.6 in Æ09, the admission rate dropped from 39% in 08 to 35% in Æ09. However patient satisfaction went up significantly from the 33rd% to 95th% in spite of increased volume.
Conclusions: Leadership had to be held accountable for consistently engaging tools that are evidence-based. Management championing of hourly rounding and other methods that increased patient and staff satisfaction, had to be consistent and sustainable in order to improve staff and patient satisfaction while decreasing AMA and LWBS. Staff had to be presented with data, and the rationale for hardwiring rounding, which entailed both the management team and staff rounding on patients daily and hourly respectively.
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