Background: Admissions from the Emergency Department (ED) to the inpatient floor units are often inefficient; this translates to increased expense via increased length of stay (LOS), fewer available patient rooms via “patient boarding”, and an overall less positive experience for patients and their families. Reducing admission times effectively increases the capacity of the ED and improves patient satisfaction.
Methods: In order to reduce the admission time from the ED to the general medical surgical units [2 South and 3 South], a Lean Rapid Improvement Event (RIE) was completed – with interventions designed to standardize provider roles and communication. The standardization of provider communication included increased nursing involvement, use of communication templates, and prompt actions by ED physicians.
Results: Through statistical analysis [via X-bar, S charts and c-charts], a clear and notable decrease in admission times – coinciding with the implemented process changes on the general medical surgical units – is identified. However, as expected of the control group, admission times from the ED to intermediate care/step-down unit [TCU] and 4 North were relatively unaffected over this time period. Importantly, this reduced admission time did correlate with a decreased LOS in the ED – suggesting a significant benefit from the standardization of this admission process.
Conclusions: In the future, this standardization of communication may be applied to additional units of the hospital to further reduce ED LOS, increase the Emergency Department capacity, and improve the experience of our patients and their families.
