Work Systems Analysis of Emergency Nurse Patient Flow Management Using the Systems Engineering Initiative for Patient...

Area of Science:

• Healthcare Systems Engineering
• Nursing Science
• Human Factors Engineering

Background:

• Emergency nurses play a critical role in managing patient flow within emergency departments.
• Effective patient flow management is essential for timely, efficient, and safe patient care.
• Limited research exists on nursing's role in patient flow management, necessitating a deeper analysis of emergency nursing work systems.

Purpose of the Study:

• To describe the work system factors influencing emergency nurse patient flow management.
• To apply the System Engineering Initiative for Patient Safety (SEIPS) model to analyze these factors.

Main Methods:

• Grounded theory methodology was employed.
• Data collection included focus groups, interviews with 27 nurses, and 64 hours of participant observation across 4 emergency departments.
• Analysis involved coding, constant comparative analysis, and memo-writing, organized by the SEIPS work system component.

Main Results:

• Patient flow is impacted by nursing characteristics, technology, external factors, and the physical/socio-organizational environment.
• Concerns were raised regarding technology functionality, usability, accessibility, departmental capacity, resource allocation, and interdepartmental teamwork.
• Variability in staff roles, provider involvement in decisions, and management's enforcement of timing metrics were also noted.

Conclusions:

• Significant barriers impede emergency patient flow management.
• Further research is needed to quantify the impact of human factors on patient flow outcomes.
• Collaboration between administrators, human factors engineers, and nurses is crucial for enhancing emergency nursing work systems.