Improving Emergency Department Throughput: Streamlining the Admission Process and Reducing Triage-to-Provider Time In a Small Community Hospital

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J Pelgano, Jefferson School of Population Health, Thomas Jefferson University


There are numerous methods to assess the quality of services provided in an emergency department (ED). Better outcomes or reduced "left without being seen" numbers are such measures. Many of the internal processes and time spans of the ED can also be evaluated, such as length of stay (LOS). One such measurable parameter is the time period defined as the duration spanning from the initial presentation at triage to evaluation by a doctor or physician assistant (PA). This project was designed as a Plan-Do-Study-Act (PDSA) and engaged the providers directly involved in the triage process and instituted changes that streamlined the triage process and reduced the triage to provider time in a small, semi-rural community hospital. By introducing a streamlined triage process that included a conventional office chair triage and bedside triage as soon as patients started to queue up, the arrival to doctor time was shortened in the study period, compared to the immediate two week period by 35%. Moreover, the shortening of the triage to doctor time occurred during a period where the patient census increased by 18% over the immediate two week period.

Presentation: 23 minutes

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