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Updated: May 3, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
A Nurse-Led Split Flow Model for Operational Improvement
Background:
Emergency departments often face overcrowding that delays care and compromises patient safety. This quality improvement initiative implemented a nurse-led split flow model to improve throughput for Emergency Severity Index level 3 patients in a high-volume emergency department.
Methods:
Guided by principles of continuous improvement and system leadership, a multidisciplinary team restructured emrgency department operations using vertical and horizontal zoning, role redefinition, and space reallocation. Leadership facilitated change management through staged pilot testing and feedback incorporation over 6 months.
Results:
Implementation reduced door-to-provider times, enhanced patient satisfaction, and improved operational throughput. Leadership-driven decisions resulted in permanent layout changes and formal role expansion.
Conclusion:
Strategic leadership by emergency nurses enabled sustained improvements in emergency department flow and capacity. The project demonstrates how nurse-led quality improvement initiatives can drive high-impact systems change.
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