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Improving Patient Flow and Decreasing Patient Length of Stay in the Pediatric Emergency Department Through
Heather A Martin1, Marcy Noble, Jaclyn Wilmarth
1Department of Emergency Medic-ine (Dr Martin), Pediatric Emergency Nursing (Ms Noble), and Emergency Nursing (Ms Wilmarth), Univer-sity of Rochester Medical Center, Rochester, New York.
Insights
Implementing a Fast Track in pediatric emergency departments (EDs) significantly reduced wait times for low-acuity patients. This initiative improved efficiency and patient safety by managing overcrowding.
Area of Science:
- Pediatrics
- Emergency Medicine
- Healthcare Management
Background:
- Emergency departments (EDs) face overcrowding due to increased visits for low-acuity conditions.
- Overcrowding in pediatric EDs compromises patient safety and increases length of stay.
- Efficient management of low-acuity patients is crucial for ED operations.
Purpose of the Study:
- To improve the efficiency of evaluation and discharge for low-acuity patients in a pediatric ED.
- To reduce ED overcrowding and enhance patient safety.
- To implement and evaluate a Fast Track system for low-acuity pediatric patients.
Main Methods:
- A performance improvement project was initiated to develop a Fast Track system.
- An interdisciplinary team created guidelines for low-acuity patient evaluation.
- A dedicated Fast Track area was established, managed by an advanced practice provider and registered nurse team.
Main Results:
- The Fast Track system was implemented in a pediatric ED.
- Length of stay for low-acuity patients (Emergency Severity Illness score 4 or 5) decreased by 36% within 14 months (from 144 to 92 minutes).
- The Fast Track demonstrated effective and efficient care delivery for low-acuity pediatric patients.
Conclusions:
- A pediatric ED Fast Track is an effective strategy for managing low-acuity patients.
- This approach significantly reduces patient length of stay and improves ED efficiency.
- Fast Track systems enhance the timely delivery of care in pediatric emergency settings.
Abstract:
Increased utilization of the emergency department (ED) for low acuity concerns saturates EDs, leading to overcrowding. As the ED becomes crowded, the quality of care threatens patient safety and increases length of stay. To improve the efficiency of evaluation and discharge of low acuity patients in the pediatric ED, a performance improvement project was implemented to develop a Fast Track. An interdisciplinary team developed the process of Fast Track, as well as guidelines for low acuity patients who would be evaluated in the designated area by an advanced practice provider and registered nurse team. Within 14 months of operating, length of stay of low acuity patients triaged an emergency severity illness score of 4 or 5 dropped 36% (from 144 to 92 min). Pediatric patients who present to the ED with low acuity concerns can be effectively and efficiently cared for in a timely fashion in a pediatric ED Fast Track.
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