Affiliations

Advocate Condell Medical Center

Presentation Notes

Quality Improvement poster 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: Advocate Condell Medical Center in 2022 had an average left without being seen (LWBS) rate of 7.5% with some months exceeding >20% of the patient they serve. Many patients were leaving the emergency department prior to a provider evaluation, which increases the risk of safety events.

Local Problem: The national average for an Emergency Department LWBS rate is

Method: Rapid Medical Evaluation (RME) is an emergency department process developed by the Vituity Medical Group to decrease patients leaving prior to medical care and to increase overall team collaboration and engagement. RME is a forward facing provider that screens in collaboration with a team of nurses and ED techs that initiates patient care. This study utilized mixed methodologies of research to evaluate this program. In the first method, Vituity leadership surveyed data over the course of several months to gain insight into potential areas where processes could be enhanced to decrease patient waiting room times. In a second method, both Vituity and Condell leadership teams utilized process of observation to establish baseline team dynamics and overall functionality in the emergency department and then correlated this to patient wait times and satisfaction with care.

Results: LWBS decreased from an average of 7.5 % prior to RME initiation to 2.5% after initiation of RME. Thus, utilizing a provider, in conjunction with a care team of nurses and technicians in the triage setting can increase Emergency Department throughput while decreasing the LWBS.

Implications for Practice: Implementing a dynamic team approach with a forward facing provider in the triage process, RME staff drives care starting from patient arrival by allowing medical providers to promptly identify patient needs and coordinate care easily. Hence, the ED Leadership team has devoted a team of nurses and techs along with a provider each day to support the RME process for the patient they serve.

Document Type

Poster

Publication Date

11-15-2023


 

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Nov 15th, 12:00 AM

Use of rapid medical evaluation in the emergency department setting

Background: Advocate Condell Medical Center in 2022 had an average left without being seen (LWBS) rate of 7.5% with some months exceeding >20% of the patient they serve. Many patients were leaving the emergency department prior to a provider evaluation, which increases the risk of safety events.

Local Problem: The national average for an Emergency Department LWBS rate is

Method: Rapid Medical Evaluation (RME) is an emergency department process developed by the Vituity Medical Group to decrease patients leaving prior to medical care and to increase overall team collaboration and engagement. RME is a forward facing provider that screens in collaboration with a team of nurses and ED techs that initiates patient care. This study utilized mixed methodologies of research to evaluate this program. In the first method, Vituity leadership surveyed data over the course of several months to gain insight into potential areas where processes could be enhanced to decrease patient waiting room times. In a second method, both Vituity and Condell leadership teams utilized process of observation to establish baseline team dynamics and overall functionality in the emergency department and then correlated this to patient wait times and satisfaction with care.

Results: LWBS decreased from an average of 7.5 % prior to RME initiation to 2.5% after initiation of RME. Thus, utilizing a provider, in conjunction with a care team of nurses and technicians in the triage setting can increase Emergency Department throughput while decreasing the LWBS.

Implications for Practice: Implementing a dynamic team approach with a forward facing provider in the triage process, RME staff drives care starting from patient arrival by allowing medical providers to promptly identify patient needs and coordinate care easily. Hence, the ED Leadership team has devoted a team of nurses and techs along with a provider each day to support the RME process for the patient they serve.

 

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