Reducing low acuity length of stay a care paradigm transition
Nicholas Wilson, BSN, RN; Michelle Reed, MSN, RN, CEN, NE-BC
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Wilson, Nicholas by View
Popular Works for Wilson, Nicholas by Download
Poster presentation, Session E presented Friday, September 15, 2017
Purpose: Emergency Department overcrowding is an epidemic in the United States. Use of services is often utilized by patients that do not require the level of care that we often provide. As a result length of stay in this patient population is sometimes extreme. Additionally, this population often times ties up resources that could be utilized to care for sicker and more acute patients. Creating a que or wait for patients is an unsafe practice and lends to less overall effeicient Emergency Departments.
Design: The study that we performed was a quality assurance project. We identified a group of patients that had lengthy waits which could lend to unsafe practices and developed a care model to expodite the care that these patients recieved.
Setting: 24 bed rural Emergency Department located about 45 minutes from the closest Level One trauma center. We see approx 50,000 patients annually, traditionally have had issues with long length of stays for less acute patients.
Participants/Subjects: All ED staff participated in this project. We did select a committee of teammembers that represented all ED job categories for implementation of our rapid assessment area.
Methods: After evaluation of 2015 data, using this is our baseline for tracking, we developed a plan that was named Direct Care. A team was indentified to design a work flow where low acuity patients could be seen in a timely manner in an already existing area in our Emergency Department. After several months of planning, we designed a care paradigm using LEAN principles of promoting effecieny and reducing waste in movement of staff, patients and equiptment. A carousel design was constructed that used 3 treatment rooms for use of assessment, treatment and discharge. A sub waiting area comprised of 3 chairs was constructed for the non-value added purpose of waiting. Patients are moved from the treatment room to subwaiting area while waiitng for procedures or radiology exams. This allowed more patients to be presented to the provider in a more timely manner. We used data from prior year to identify number of patients seen each day on a historical level, identifying what hours of the day we would need to operate this expodited care area to reduce patient waiting, also know as cueing theory.
Results/Outcomes: In the first half of 2016 our overall length of stay for low acuity patients was around 135 minutes, after the implementation of this care area we saw a decrease in length of stay to about 95 minutes. Not only were we able to successfully decrease overall length of stay in this population but greatly decreased the door to physician times as well which is thought to be highly correlated with quality of care. Have drastically reduced our waits in low acuity to patients to often times having no wait.
Implications: Using the above data in results/outomes, you will see that in current care paridigm we are now able to see 3 patients in the same time that we saw 2 prior year. Improved efficiency, quality, safety and service excellence.
ENA 2017: Education, Networking, Advocacy. Held at America's Center Convention Center, St. Louis, Missouri, USA
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository, unless otherwise noted.
|Abstract Review Only: Reviewed by Event Host
Length of Stay;
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
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.
Showing items related by title, author, creator and subjects.
Slivinski, Andrea K. (2016-09-16)Session presented on Sunday, September 18, 2016: Purpose: Organizations should adopt evidence-based strategies to reduce ED length of stay and improve the overall patient experience. The purpose of this project was to ...
Low acuity emergency department visits: Comparing demographics and patient profiles for an accountable care organization Wagner, Vicki Lynn (2017-06-06)Frequent non-urgent emergency department (ED) visits have escalated despite legislation to enact routine affordable care for all Americans. It is already known that ED overcrowding often limits hospital functional ...
Watson, Brandon; Borkowski, Konrad; Conca-Petit, Jonathan (5/18/2017)Overcrowding in emergency departments (EDs) is a national crisis affecting hospitals. It has led to an association with poor patient outcomes and is a threat to public safety. Fast tracks (FTs) in the ED are one strategy ...
Carr, Meredith; Popowycz, Nicholas; Bowen, Emily; Denis, Liset; Prewitt, Judy; White, AnnSession D presented Thursday, September 27, 2:30-3:30 pm Purpose: There is no more vulnerable a time for a patient than during handoff and transfer from the ED to an inpatient unit. That transition is fraught with ...
Randomized controlled study in the use of aromatherapy for pain reduction and to reduce opioid use in the emergency department Brown, Adam N.; Reed, Cindy; Rhew, Denise C.; Adkins, Crystal; Tai, MerleThe purpose of this study is to evaluate the effectiveness of a combination of lavender, sweet marjoram, and pink grapefruit oils on a patient’s perception of pain, and the ability to reduce the use of opioids in an ...