Improving Patient Flow From the Emergency Department Utilizing a Standardized Electronic Nursing Handoff Process
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Lisa Potts1, Catherine Ryan, Lauren Diegel-Vacek
1Author Affiliations: Senior Director of Patient Care Services and Interim Associate Chief Nursing Officer (Dr Potts), University of Illinois Hospital & Health Sciences System; Clinical Associate Professor (Dr Ryan) and Clinical Assistant Professor (Dr Diegel-Vacek), University of Illinois at Chicago College of Nursing Department of Biobehavioral Health Sciences; and Director (Dr Ryan), Evidence-Based Practice, University of Illinois Hospital, Chicago; and Vice President of Patient Services and Chief Nursing Officer (Dr Murchek), Franciscan Health Hammond, Indiana.
Objective:
The goal of this project was to decrease handoff delays from the emergency department (ED) as measured by ready to move (RTM)-to-occupied time.
Background:
ED boarding compromises the quality, safety, and experience of patient care. Lack of standardized and transparent handoff communication contributes to boarding time. This process improvement initiative implemented a standardized electronic situation, background, assessment, and recommendation (eSBAR) format-based nursing handoff process from the ED to a medical unit.
Methods:
Nursing staff were educated face-to-face regarding the initiative background, significance, and process. Outcomes were measured before and after eSBAR implementation.
Results:
Before implementation, the house-wide average RTM-to-occupied time was 83.6 minutes. This decreased to 49 minutes (a 41.4% decrease) 3 weeks after implementation and improved further to 47 minutes at 10 months after implementation. No related patient safety or quality issues were identified.
Conclusions:
The use of an electronic, standardized handoff communication process resulted in decreased boarding time and increased bed flow efficiency.
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