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Health Care Provider in Triage to Improve Outcomes.
J Emerg Nurs. 2019 Sep; 45(5):561-566.JE

Abstract

PROBLEM

Emergency departments throughout the nation are experiencing crowding related to increased patient volumes and decreased hospital inpatient bed capacity. As a result of lengthy wait times, patients are leaving without having medical treatment, and satisfaction is poor. The purpose of this quality improvement initiative was placing a provider in triage to complement the existing split-flow process aimed to decrease wait times to see a provider, length of stay (LOS), left without being seen (LWBS) rates, and improve patient satisfaction.

METHODS

A multiprofessional team was established. Nurses, advanced practice providers, and physicians collaborated on a project to place a provider in triage to assist in seeing patients as soon as possible and begin care or treatment.

RESULTS

The outcomes of the initiative were positive for ED LOS metrics and patient satisfaction. Door-to-provider time decreased from a high of 56 minutes to a low of 13 minutes. The percentage of patients LWBS decreased from a high of 12% to a low of 1.62%.

DISCUSSION

The project showed that the evidence-based practice of a combined split-flow and provider-in-triage model resulted in improvements in throughput for patients who were treated and released from the emergency department.

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Authors

Spencer S
No affiliation info available
Stephens K
No affiliation info available
Swanson-Biearman B
No affiliation info available
Whiteman K
No affiliation info available

MeSH

Emergency NursingEmergency Service, HospitalHealth PersonnelHumansLength of StayPatient SatisfactionPhysiciansQuality ImprovementTriage

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30827577

Citation

Spencer, Susan, et al. "Health Care Provider in Triage to Improve Outcomes." Journal of Emergency Nursing, vol. 45, no. 5, 2019, pp. 561-566.
Spencer S, Stephens K, Swanson-Biearman B, et al. Health Care Provider in Triage to Improve Outcomes. J Emerg Nurs. 2019;45(5):561-566.
Spencer, S., Stephens, K., Swanson-Biearman, B., & Whiteman, K. (2019). Health Care Provider in Triage to Improve Outcomes. Journal of Emergency Nursing, 45(5), 561-566. https://doi.org/10.1016/j.jen.2019.01.008
Spencer S, et al. Health Care Provider in Triage to Improve Outcomes. J Emerg Nurs. 2019;45(5):561-566. PubMed PMID: 30827577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health Care Provider in Triage to Improve Outcomes. AU - Spencer,Susan, AU - Stephens,Kimberly, AU - Swanson-Biearman,Brenda, AU - Whiteman,Kimberly, Y1 - 2019/03/01/ PY - 2018/12/14/received PY - 2019/01/02/revised PY - 2019/01/15/accepted PY - 2019/3/5/pubmed PY - 2020/2/13/medline PY - 2019/3/5/entrez KW - ED wait times KW - Left without being seen KW - Overcrowding KW - Provider in triage KW - Split flow KW - Throughput SP - 561 EP - 566 JF - Journal of emergency nursing JO - J Emerg Nurs VL - 45 IS - 5 N2 - PROBLEM: Emergency departments throughout the nation are experiencing crowding related to increased patient volumes and decreased hospital inpatient bed capacity. As a result of lengthy wait times, patients are leaving without having medical treatment, and satisfaction is poor. The purpose of this quality improvement initiative was placing a provider in triage to complement the existing split-flow process aimed to decrease wait times to see a provider, length of stay (LOS), left without being seen (LWBS) rates, and improve patient satisfaction. METHODS: A multiprofessional team was established. Nurses, advanced practice providers, and physicians collaborated on a project to place a provider in triage to assist in seeing patients as soon as possible and begin care or treatment. RESULTS: The outcomes of the initiative were positive for ED LOS metrics and patient satisfaction. Door-to-provider time decreased from a high of 56 minutes to a low of 13 minutes. The percentage of patients LWBS decreased from a high of 12% to a low of 1.62%. DISCUSSION: The project showed that the evidence-based practice of a combined split-flow and provider-in-triage model resulted in improvements in throughput for patients who were treated and released from the emergency department. SN - 1527-2966 UR - https://www.unboundmedicine.com/medline/citation/30827577/Health_Care_Provider_in_Triage_to_Improve_Outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0099-1767(18)30695-0 DB - PRIME DP - Unbound Medicine ER -