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Recommended Citation
Edmunds K, Archer N, Olshan-Perlmutter M, Boggess M. A nursing led initiative in collaboration with the Performance of Excellence Center to change psychiatric emergency department triage procedures to improve patient care. Quality Improvement 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.
Presentation Notes
Quality Improvement 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
Psychiatric emergency room visits are often associated with long wait times, leading to agitation and dissatisfaction among patients, delay in care, some patients leaving without receiving care, staff frustration and increased cost. Research indicates that triage guidelines correlate with wait times and patient satisfaction.
Local Problem
Atrium Health Charlotte is a dedicated psychiatric emergency room that has consistently seen an increase in yearly patient visits. Overcrowding and long wait times are commonplace. Last year almost 10,000 patients were seen, and 839 left without being seen. The average time for patients’ length of stay from door to discharge was 245 minutes.
Method
The methodology used to develop a triage policy, Provider in Triage, was part of a rapid improvement project done in conjunction with the Performance Excellence Center. The goal was to mainstream triage for low complexity patients. A sorting nurse does a brief assessment to determine patient eligibility if eligible triage nurse and provider assesses the patient together. This will enhance collaboration, decrease redundancy, and wait times, expedite care, and decrease patients leaving without being seen.
Results/Conclusions
Provider in Triage initiative was positive for decreasing length of stay metrics for low complexity patients and for patients who presented, requiring thorough assessment and admission to Observation unit. Door to discharge time decreased for low acuity patients by 25.3% from 245 minutes to 193 minutes. Door to admission to Observation unit decreased by 21.5% from 265 minutes to 208 minutes. In addition, the percentage of patients leaving without being seen decreased by 94%.
Implication for Practice
These findings suggest that provider in triage improves efficiency, communication between disciplines and decreases redundancy. This process leads to a decrease in patients' wait time, patients leaving without being seen and allows staff to quickly initiate treatment planning and implementation.
Document Type
Oral/Podium Presentation
Publication Date
11-15-2023
A nursing led initiative in collaboration with the Performance of Excellence Center to change psychiatric emergency department triage procedures to improve patient care
Background
Psychiatric emergency room visits are often associated with long wait times, leading to agitation and dissatisfaction among patients, delay in care, some patients leaving without receiving care, staff frustration and increased cost. Research indicates that triage guidelines correlate with wait times and patient satisfaction.
Local Problem
Atrium Health Charlotte is a dedicated psychiatric emergency room that has consistently seen an increase in yearly patient visits. Overcrowding and long wait times are commonplace. Last year almost 10,000 patients were seen, and 839 left without being seen. The average time for patients’ length of stay from door to discharge was 245 minutes.
Method
The methodology used to develop a triage policy, Provider in Triage, was part of a rapid improvement project done in conjunction with the Performance Excellence Center. The goal was to mainstream triage for low complexity patients. A sorting nurse does a brief assessment to determine patient eligibility if eligible triage nurse and provider assesses the patient together. This will enhance collaboration, decrease redundancy, and wait times, expedite care, and decrease patients leaving without being seen.
Results/Conclusions
Provider in Triage initiative was positive for decreasing length of stay metrics for low complexity patients and for patients who presented, requiring thorough assessment and admission to Observation unit. Door to discharge time decreased for low acuity patients by 25.3% from 245 minutes to 193 minutes. Door to admission to Observation unit decreased by 21.5% from 265 minutes to 208 minutes. In addition, the percentage of patients leaving without being seen decreased by 94%.
Implication for Practice
These findings suggest that provider in triage improves efficiency, communication between disciplines and decreases redundancy. This process leads to a decrease in patients' wait time, patients leaving without being seen and allows staff to quickly initiate treatment planning and implementation.