Reimagining the Delivery of Emergency Medicine

Abstract

Introduction: Emergency departments are experiencing higher volumes of patients, where overcrowding and boarding have become a normal everyday occurrence. These barriers force hospitals and specifically emergency departments to think differently when it comes to caring for patients. The old split flow model of care is no longer sufficient to move patients safely, effectively, and timely through the continuum of emergency care. This project focuses on innovating emergency department throughput and identifies new road maps to decrease the time a patient spends in the emergency department.

Methods: A multi-disciplinary team was created including nurses, physicians, patient care assistants, transporters, radiology, and patient liaisons. The team was tasked to completely reimagine a new innovative emergency care model. Go-live would be in 60 days. The challenge was to create superior emergency department throughput strategies that did not rely on the hospital having capacity. Post-implementation metrics were measured for eight months.

Results: Vast improvement was noted in nearly every emergency department metric upon go-live. Length of stay decreased by nearly 25%, left without being seen decreased to nearly 0%, left before treatment complete decreased to below 1%, and patient satisfaction more than doubled.

Conclusion: Using data analysis as the foundation for creating an innovative emergency care model was able to improve throughput inefficiencies experienced with the previous split flow model at an overcrowded urban hospital.

Contribution to Emergency Nursing Practice: This quality improvement project developed a new care delivery model for emergency departments which are experiencing overcrowding related throughput inefficiencies.
• Key implications for emergency nursing practice found in this article are that interdisciplinary collaboration is key to improving emergency
department throughput.
• This article places an emphasis on utilizing data analysis to drive emergency department throughput decision making.