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Improving Timeliness of Pediatric Emergency Department Admissions
Insights
A new process improved pediatric patient admissions from the emergency department (ED) to inpatient units. This quality improvement initiative reduced admission times, enhancing patient care and flow within the hospital.
Area of Science:
- Pediatric Emergency Medicine
- Quality Improvement Science
- Healthcare Operations Management
Background:
- Pediatric patients presenting to emergency departments (EDs) at Level I pediatric trauma centers often require inpatient admission.
- Improving the timing, communication, and continuity of care for these patients is crucial.
Purpose of the Study:
- To implement and evaluate a quality improvement project aimed at optimizing the patient flow process for pediatric admissions.
- To decrease the time from the decision to admit to the actual inpatient admission for pediatric patients.
Main Methods:
- Utilized continuous improvement methodology to design a new patient flow process.
- Implemented a collaborative workflow involving emergency department (ED) and inpatient nursing staff, with nursing leaders coordinating transfers.
- Focused on reducing the time from decision to admit to actual admission.
Main Results:
- The average time from decision to admit to actual admission for patients admitted to a short-stay pediatric unit decreased from 106.8 minutes to 82.84 minutes.
- The percentage of patients admitted within 60 minutes improved from 59.75% to 68.75%.
- The successful model was subsequently replicated across other hospital units.
Conclusions:
- This quality improvement project established a successful model for efficient, time-controlled patient admissions from the pediatric ED to inpatient units.
- There is a need for further research to establish benchmarks for pediatric admission timing and to assess other measurable impacts on patient care.
Introduction:
The goal of this quality improvement project was to improve timing, communication, and continued care for pediatric patients who present to the emergency department at a Level I pediatric trauma center and require inpatient admission.
Methods:
Using continuous improvement methodology, a patient flow process was created to improve the throughput of pediatric patients requiring inpatient admission from the emergency department, aimed at decreasing the time from decision to admit to actual admission. The new workflow included ED and inpatient nursing collaboration, with nursing leaders coordinating patient transfer.
Results:
Baseline data indicated that, in 2019, patients admitted to a short-stay pediatric unit from the emergency department had an average time of 106.8 minutes from decision to admit to the actual admission. After the implementation of a new admission process, time from decision to admit to actual admission decreased from a mean of 106.8 minutes to 82.84 minutes for patients admitted to a short-stay unit. This illustrates an improvement from 59.75% to 68.75% of patients admitted within 60 minutes from ED admission to arrival on a short-stay unit. This model was then replicated throughout other units in the hospital.
Discussion:
There are no known benchmark data to guide practice for rapid admission from the pediatric emergency department to inpatient units and continuing care. This quality improvement project demonstrates a model that has been successful admitting patients in an efficient, time-controlled manner. Additional research is needed to document benchmarks for admission timing and to demonstrate other measurable outcomes in patient care.
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