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Improving Throughput for Patients Admitted From the Emergency Department: Implementation of a Standardized Report
Eric Wolak1, Cheryl Jones, Jennifer Leeman
1Medicine and Inpatient Oncology (Dr Wolak), University of North Carolina Hospitals, Chapel Hill (Dr Madigan); and The University of North Carolina at Chapel Hill School of Nursing (Drs Jones and Leeman).
Background:
Inefficient emergency department to inpatient handoff processes can contribute to delayed care.
Local Problem:
The average emergency department length of stay for admitted patients and admission wait times at this institution were well above national averages, and a standard handoff process was lacking.
Methods:
Lean methodology was used to evaluate flow and identify opportunities for improvement.
Interventions:
Two tools were developed to standardize handoff.
Results:
Emergency department length of stay and admission wait times were not significantly improved following intervention implementation. However, patient transfer time decreased significantly (P < .01, F = 29.02) from 30.5 minutes (SD = 18.2) to 21.7 minutes (SD = 7.4). The length of time to give/receive report also decreased significantly (P = .04, F = 2.2) from 3.8 (SD = 1.6) minutes to 2.8 (SD = 1.2) minutes.
Conclusions:
Although length of stay and admission wait times did not decline significantly, implementation of standard work and tools can potentially improve patient flow.
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