Related Experiment Videos
Appropriate admissions to the appropriate unit: a decision tree approach
Joanne Matukaitis1, Paula Stillman, Elizabeth Wykpisz
1Patient Care Services, Critical Care, Newark, DE 19713, USA. jmatukaitis@christianacare.org
Summary
A new intermediate care decision tool and charging process improved patient flow and reduced emergency department wait times. This acuity adaptable model of care optimized bed utilization and nursing costs.
Area of Science:
- Healthcare Management
- Nursing Administration
- Patient Flow Optimization
Background:
- Increasing demand for intermediate care beds presents a challenge for healthcare systems.
- Current models may lead to prolonged emergency department (ED) wait times for intermediate care (IMC) beds.
- Need for efficient resource allocation and adaptable care models.
Purpose of the Study:
- To develop and evaluate an intermediate care decision tree tool.
- To implement an acuity adaptable model of care (AMC) with a supportive charging process.
- To assess the impact of these interventions on patient flow, wait times, and costs.
Main Methods:
- Development of a decision tree for IMC bed allocation.
- Implementation of an AMC allowing patients to remain in one bed with adjusted nurse-to-patient ratios.
- Pilot study tracking patient admissions from the ED to IMC.
Main Results:
- 96%-100% of ED patients met IMC admission criteria during the pilot.
- Wait time from request to admission reduced from 5.5 to 2.5 hours.
- Significant reduction in daily ED patient wait times (approx. 80%) and noted reduction in nursing costs.
Conclusions:
- The implemented decision tree and AMC effectively met the demand for IMC beds.
- The interventions significantly improved patient throughput from the ED.
- The acuity adaptable model demonstrated potential for cost savings and improved ED efficiency.