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Improving the wait time to triage at the emergency department
1Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore shen.yuzeng@singhealth.com.sg.
BMJ Open Quality
|February 6, 2020
Summary
Implementing plan-do-study-act cycles reduced emergency department (ED) wait times for triage. This quality improvement initiative decreased average triage wait times by 25%.
Area of Science:
- Emergency Medicine
- Healthcare Quality Improvement
- Healthcare Management
Background:
- Emergency department (ED) patient flow is critical for timely care.
- Long wait times to triage negatively impact overall consultation duration.
- Optimizing triage processes is essential for improving patient experience and outcomes.
Purpose of the Study:
- To assess the effectiveness of plan-do-study-act (PDSA) cycles in reducing ED patient triage wait times.
- To evaluate sustained improvements in triage efficiency over a one-year period.
- To identify key interventions for enhancing ED triage processes.
Main Methods:
- Implementation of sequential PDSA cycles targeting triage efficiency.
- Interventions included refining triage criteria, direct bedding by senior nurses, and establishing a triage nurse clinician role.
- Data collection spanned a baseline period (Jan-Apr 2017) and post-implementation (May 2017-Mar 2019).
Main Results:
- Average wait time to triage decreased from 18 minutes to 13 minutes.
- Variance in wait times reduced by 25% (from 16 to 12 minutes).
- Improvements in triage wait times were sustained post-implementation.
Conclusions:
- PDSA cycles are effective in significantly reducing ED triage wait times.
- Adequate nursing manpower, data-driven decisions, and stakeholder engagement are crucial for successful quality improvement.
- Sustained improvements highlight the value of continuous quality initiatives in emergency care settings.
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