Mount St. Mary’s Hospital developed an emergency department (ED) throughput initiative in response to patient satisfaction surveys and safety initiatives from The Joint Commission for improving wait times and patient safety.The initiative had two goals: (1) move patients from the point of entry to meeting with the medical provider as quickly as possible and (2) increase communication with the patient and his/her family members to keep them informed and move them through the system safely.
TeamHealth worked with Mount S. Mary’s administrative and clinical leadership teams to develop a new patient flow process designed to move patients through the department quickly, safely and comfortably. The new process includes pivot/triage areas to allow for quick evaluation upon arrival, a patient fast track for the least severe cases, and a results waiting area to free-up bed space when applicable. Using a split-flow design, the least sick patients can be treated and released from the fast track without occupying an ED bed. And a “pod”structure allows nurses to take greater ownership of their patients’ outcomes.The new design involves the constant transfer of information between front line nursing staff, managers,and administrative staff to keep the process flowing smoothly. TeamHealth worked with administrative personnel, medical and provider staff, nursing, nurse attendants, volunteer staff, and transport personnel,among many other ancillary staff members, to hard wire the flow process.
With the engagement of the hospital’s chief executive officer, vice president of nursing, and countless members of the staff, the initiative garnered the support, belief in the process, and momentum needed to succeed.It broke new ground in an organization and department that previously believed in a “we have always done it this way” approach.Since implementing the throughput initiative, the ED has seen dramatic improvements, including:
- Better patient satisfaction scores and outcomes
- Decreases in the number of patients who leave prior to examination or triage
- Reduced wait times
- Increased collaboration and satisfaction among medical providers and staff
- Enhanced HCAHPS scores
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