Improving patient flow from the emergency department (ED) to the inpatient floors has been a focus for Sibley’s nurses and leadership since early 2019 when the ED experienced an unexpected increase in patients. It has only grown more pressing during the COVID-19 pandemic. Now, not only do patients need to be quickly moved to their inpatient unit for their own safety and comfort, the staff needs extra time for cleaning and decontamination before the next patient can be brought back for care.
Nurses like Lisa Salas, an ED night shift charge nurse, know what a difference a smooth transition can make for patients.
As someone intimately involved in the complex process as part of her day-to-day duties, Salas is passionate about improving that experience as much as possible for every patient who enters the hospital.
“They need to get upstairs to their admitted bed—we want to make sure that they are comfortable, in the proper hands and getting the proper care as soon as possible,” she says.
Salas started her throughput efforts where she works—on the ED’s night shift. She now regularly brings recommendations to the ED’s throughput discussions so what works can also be replicated on day shift. For example, she implemented a different workflow for triage nurses when technicians aren’t available to assist with first-touch patient assessments.
Salas and colleagues in the emergency department, including nurse manager Christine Weimer, remain committed to participating in the hospital-wide throughput work group, which is made up of every units’ nurse managers, all the nursing directors, the environmental services director, and patient registration and nursing coordinators. The work group meets monthly and discusses throughput at a granular level—bringing specific cases as examples to identify and break down all the barriers to a smooth process, wherever they exist in the hospital.
“Throughput is a bigger issue than the emergency department,” says Weimer. “Looking at these issues from only the ED perspective is extremely limiting. Throughput is complex.”