A Nurse-Led Split Flow Model for Operational Improvement

Area of Science:

• Healthcare Management
• Quality Improvement
• Nursing Leadership

Background:

• Emergency departments (EDs) experience overcrowding, leading to care delays and compromised patient safety.
• A high-volume ED implemented a nurse-led split flow model to address throughput issues for Emergency Severity Index (ESI) level 3 patients.

Purpose of the Study:

• To evaluate the effectiveness of a nurse-led split flow model in improving ED patient flow and operational efficiency.
• To assess the impact of strategic leadership and multidisciplinary collaboration on ED operations.

Main Methods:

• A multidisciplinary team restructured ED operations using vertical and horizontal zoning, role redefinition, and space reallocation.
• Change management involved staged pilot testing and feedback incorporation over a 6-month period, guided by continuous improvement principles.

Main Results:

• The split flow model implementation significantly reduced door-to-provider times.
• Patient satisfaction and overall operational throughput in the ED were enhanced.
• Leadership decisions led to permanent layout modifications and expanded formal roles.

Conclusions:

• Strategic emergency nurse leadership facilitated sustained improvements in ED flow and capacity.
• This nurse-led quality improvement initiative successfully drove high-impact systems change within the ED.
• The model highlights the potential for nursing leadership to optimize emergency care delivery.