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Presentation Notes

Evidence Based Practice podium presentation at Empowering Nursing Excellence: Recognizing the Value and Impact of Nurses, Advocate Health Midwest Region Nursing Research & Professional Development Conference 2023; November 15, 2023; virtual.

Abstract

Background:

According to the CDC’s (2019) review of health care data in 2019, over 150 million patients were seen in Emergency Departments across the United States. Of these patients, more than 20 million were admitted to the hospital. Longer Emergency Department wait times equate to worse patient outcomes, including higher in-hospital mortality rates and increased occurrence of in-hospital cardiac arrest.

Handoff is considered a high-risk activity (Freel & Flaherty, 2021). Studies have shown most effective handoff tools include the use of mnemonics or tools to aid in the organization of critical information (Kear, 2016).

Aim or purpose of the initiative:

The project was aimed at the population (P) of adult ED patients who are admitted to the inpatient units. The intervention (I) is to implement a uniform handover report tool to decrease ED length of stay and increase patient and nursing satisfaction.

Implementation Plan:

An electronic handoff tool was created in Epic and education was provided to ED and inpatient nursing unit nurses. A nurse leader rounding form was used to interview selected patients to assess satisfaction with the admission process. Nurses were given a Likert Scale survey to assess satisfaction with handover before and after implementation.

Outcomes:

After implementation, there was a decrease in length of stay in the Emergency Department with most patients admitted within 60 minutes or less, compared to the previous time of 75 minutes or longer. Although nursing satisfaction did not improve with the new handoff tool, there was a strong association between communication and patient satisfaction.

Implications for practice:

Wait time and decreased length of stay as well as quality of communication between providers and patients in the Emergency Department are important determinants of patient satisfaction. The implantation of the electronic handoff tool served as an aid in communication with resulted in decreased Emergency Department length of stay. Reevaluation of the current handoff model is one way to increase nursing satisfaction.

Document Type

Oral/Podium Presentation

Publication Date

11-15-2023


 

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Nov 15th, 12:00 AM

Ready, set, go! Implementing an electronic handoff tool to decrease emergency department length of stay

Background:

According to the CDC’s (2019) review of health care data in 2019, over 150 million patients were seen in Emergency Departments across the United States. Of these patients, more than 20 million were admitted to the hospital. Longer Emergency Department wait times equate to worse patient outcomes, including higher in-hospital mortality rates and increased occurrence of in-hospital cardiac arrest.

Handoff is considered a high-risk activity (Freel & Flaherty, 2021). Studies have shown most effective handoff tools include the use of mnemonics or tools to aid in the organization of critical information (Kear, 2016).

Aim or purpose of the initiative:

The project was aimed at the population (P) of adult ED patients who are admitted to the inpatient units. The intervention (I) is to implement a uniform handover report tool to decrease ED length of stay and increase patient and nursing satisfaction.

Implementation Plan:

An electronic handoff tool was created in Epic and education was provided to ED and inpatient nursing unit nurses. A nurse leader rounding form was used to interview selected patients to assess satisfaction with the admission process. Nurses were given a Likert Scale survey to assess satisfaction with handover before and after implementation.

Outcomes:

After implementation, there was a decrease in length of stay in the Emergency Department with most patients admitted within 60 minutes or less, compared to the previous time of 75 minutes or longer. Although nursing satisfaction did not improve with the new handoff tool, there was a strong association between communication and patient satisfaction.

Implications for practice:

Wait time and decreased length of stay as well as quality of communication between providers and patients in the Emergency Department are important determinants of patient satisfaction. The implantation of the electronic handoff tool served as an aid in communication with resulted in decreased Emergency Department length of stay. Reevaluation of the current handoff model is one way to increase nursing satisfaction.

 

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