Transforming ED Operations to Better Serve Our Patients

Patricia Altman, MSN, RN, CEN, Chase Lodico, MBA, BSN, RN, CEN, Marites Gonzaga-Reardon, APRN, CCNS, CEN, Magdalena Nowakowski, BSN, RN, CEN, Galeta C. Clayton, MD

In May 2018, a team of ED physicians, nurses, and leaders came together to investigate root causes and brainstorm solutions to help improve the efficiency of patient care to reduce patient wait times in the Emergency Department (ED).

Armed with patient and staff feedback, observations, and data analysis, the team came up with four adjustments to the way the ED operates:

  1. ED staffing schedules were changed to better align with patient arrivals. For example, some shifts were moved from day to night for both physicians and nurses, to accommodate the number of patients who come to the ED later in the day.
  2. The physical layout of the ED was adjusted to enable better flow for patients, including the opening of three areas with dedicated staff to more efficiently progress care for our patients and help ease effects of long wait times.
  3. New processes and procedures were developed and documented and our staff was trained to ensure the same patient experience is delivered the same way every single time.
  4. An electronic system was deployed to help track patient flow in real-time, allowing the ED to identify issues and respond to delays more rapidly.

As a result of these efforts, improvements are beginning to be actualized. There was an overall decrease in wait time after the four adjustments were made in September 2019.

In our commitment to improve patient experience and decrease wait times in the ED, the team continues to make adjustments to improve operations. One such initiative is collaboration with ED support partners to improve turnaround times, particularly for images, labs, bed cleans, and inpatient bed requests ordered for ED patients.

Danica Uzelac, ASFA 2018 poster presentation
Nurse-Led Projects