Closing the Gap in Direct Admissions: A Quality Improvement Project

Area of Science:

• Healthcare Management
• Quality Improvement in Healthcare
• Patient Flow Optimization

Background:

• Direct admissions (DAs) bypass the emergency department for nonemergent cases.
• Lack of a standardized DA process led to delayed patient care.
• Existing DA procedures required optimization to improve efficiency.

Purpose of the Study:

• To review and modify the direct admission process.
• To decrease the time from patient arrival to initial clinician orders.
• To maintain or improve patient satisfaction scores.

Main Methods:

• Utilized quality improvement tools, including Define-Measure-Analyze-Improve-Control (DMAIC), fishbone diagrams, and process mapping.
• Focused on streamlining the direct admission workflow.
• Set a target to reduce average time from 84.4 minutes to 60 minutes or less.

Main Results:

• The standardized direct admission process reduced the average time from patient arrival to clinician order placement to under 60 minutes.
• The streamlined process did not negatively affect patient admission loyalty scores.
• Achieved target efficiency goals for direct admissions.

Conclusions:

• A standardized direct admission process improves patient care timeliness.
• Quality improvement methodologies are effective in optimizing hospital workflows.
• Efficient direct admission processes can be implemented without compromising patient satisfaction.