Health Care Provider in Triage to Improve Outcomes

Area of Science:

• Healthcare Management
• Emergency Medicine
• Quality Improvement

Background:

• Emergency departments (EDs) face crowding due to high patient volumes and limited inpatient bed capacity.
• Crowding leads to extended wait times, resulting in patients leaving without treatment and decreased patient satisfaction.

Purpose of the Study:

• To implement a quality improvement initiative by placing a provider in triage.
• To complement the existing split-flow process to decrease wait times, length of stay (LOS), and left without being seen (LWBS) rates.
• To enhance overall patient satisfaction in the emergency department.

Main Methods:

• A multiprofessional team comprising nurses, advanced practice providers, and physicians was formed.
• The team collaborated to integrate a provider into the triage process.
• The goal was to expedite patient assessment and initiate care promptly.

Main Results:

• The initiative positively impacted ED LOS metrics and patient satisfaction.
• Door-to-provider time decreased significantly from 56 minutes to 13 minutes.
• The percentage of patients leaving without being seen (LWBS) dropped from 12% to 1.62%.

Conclusions:

• The evidence-based practice of combining split-flow with a provider-in-triage model demonstrated effectiveness.
• This model led to improved patient throughput for those treated and released from the ED.
• The initiative successfully addressed ED crowding and enhanced patient care delivery.