ED Triage Process Improvement: Timely Vital Signs for Less Acute Patients.

Abstract Problem Vital signs can result in an upgrade of patients' Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to mee...

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Publicado en:Journal of Emergency Nursing Vol. 44; no. 6; pp. 589 - 598
Autores principales: Falconer, Stella S., Karuppan, Corinne M., Kiehne, Emily, Rama, Shravan
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Nov2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2018
      vid: 44
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      pub: Elsevier B.V.
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        10.1016/j.jen.2018.05.006
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        atl: ED Triage Process Improvement: Timely Vital Signs for Less Acute Patients.
      aug:
        au:
          Falconer, Stella S.
          Karuppan, Corinne M.
          Kiehne, Emily
          Rama, Shravan
        affil: Springfield, MO
      sug:
        subj:
          Emergency Service
          Triage Methods
          Vital Signs
          Acute Care Psychosocial Factors
          Quality Improvement
          Human
          Emergency Care
          Time Factors
          Quality of Health Care
          Hospitals, Community
          Missouri
          Process Assessment (Health Care)
          Questionnaires
          Surveys
          Emergency Nursing
          Job Satisfaction
      ab: Abstract Problem Vital signs can result in an upgrade of patients' Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to meet required protocols while enhancing the quality and experience of care. Methods We performed process analyses to redesign the door-to-vital signs process. We also developed spaghetti diagrams to reconfigure the patient arrival area. Results The door-to-vital signs time was reduced from 43.1 minutes to 6.44 minutes. Both patients and triage staff seemed more satisfied with the new process. The patient arrival area was less congested and more welcoming. Discussion Performing activities in parallel reduces flow time with no additional resources. Staff involvement in process planning, redesign, and control ensures engagement and early buy-in. One should anticipate how changes to one process might affect other processes. Unlabelled Box Contribution to Emergency Nursing Practice • The purpose of this practice improvement initiative was to decrease door-to-vital signs time through a process redesign. • The primary outcome of this practice improvement project was that parallel processing and layout redesign can improve triage efficiency and ensure timely vital signs with no additional resources. • Key implications for emergency nursing practice based on this project are (1) triage staff should be involved early in the redesign process, and (2) process change control is imperative.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
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      ougenre: Article
    language: English
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