Triaging patients from the emergency room, an outside hospital or a service-line within your institution can be a challenging endeavor regardless of the size of your group. The Ohio State University Wexner Medical Center Division of Hospital Medicine (DoHM) faculty are the primary attendings for 21 unique service-lines each day across five hospitals. The triaging responsibilities of these services fall to a Hospitalist within the Division on a rotating basis each day. These service lines are associated with various census caps, geographic locales and clinical conditions. Given the sheer number and inherent intricacy associated with the individual service-lines there exists an opportunity for streamlining of a complex process.
Our institution continues to have growth in the number of new available beds creating the necessities of service-line census growth and new service creation. The DoHM is a primary recipient of these new opportunities. As such, the ever-growing nature of our clinical responsibilities and group necessitates workflow efficiencies and safeguards whenever possible.
The gateway to our services is the triaging process. A triage worksheet was created to assist in this process. The worksheet, maintained on internal institutional servers, is employed to allow the triaging Hospitalist to remain organized in this complex process while maintaining a secured informational record to ensure a patient is not lost to care assignment and follow up. Given the size of our group, number of daily service-lines and volume of patients triaged, having faculty contact information readily available was one key element in maximizing efficiency in this process.
The triage worksheet utilizes the ability of Microsoft ExcelTM to obtain data from outside sources to reflect shift assignments in real-time. By establishing our scheduling portal as a data source and utilizing Excel’s web query function, it is possible to pull this data into the worksheet with subsequent automated cross-linking of our internal contact information database containing pager and cell phone numbers of the 84 DoHM faculty members. By refreshing this data in real-time, we are able to create an automatically updating triage worksheet that can accurately reflect who is on service dynamically 24-hours a day with their contact information immediately available.
Overall, our faculty have reported positive results with improved workflow efficiency, effectiveness and accuracy since the incorporation of Excel’s web query function into our triage worksheet. An added bonus of this process has been the improved provider satisfaction with an otherwise arduous and tedious task. In an era of ever-increasing competing demands on Hospital Medicine providers, as our experience shows, utilization of technology to streamline workflow is a necessity that can be done without being burdensome.