Author

Aaron Bellow

Defense Date

2-24-2015

Graduation Date

2015

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Kathleen Sekula

Committee Member

Gordon Gillespie

Committee Member

Lynn Simko

Keywords

ED Crowding, ED Operations, Emergency Department, Patient Flow

Abstract

Emergency Departments have begun implementing new patient flow processes aimed at improving ED throughput and limiting ED crowding. The purpose of this study was to evaluate the effectiveness of two flow processes.

This was a retrospective quasi-experimental study designed to evaluate the impact of a Rapid Medical Assessment process versus Fast Track process on improving ED throughput. Data analysis included descriptive statistics and two-factor analyses of covariance (ANCOVA). ANCOVA statistics were calculated using "arrival to first provider contact time" and "arrival to departure time" as the dependent variables and RMA process versus FT process as well as ESI levels as the independent variables. There was a significant difference in the mean arrival to first provider contact times for all patients during all hours, F (1, 5744) = 9.5, p = .002. There was also a significant difference in the mean arrival to first provider contact time for low-acuity patients during all hours, F (1, 3131) = 14.6, p = < .001

There was a significant difference in the mean arrival to departure times for all patients during all hours, F (1, 6079) = 5.8, p = .016. There was no significant difference in the mean arrival to departure times for low-acuity patients during all hours, F (1, 3306) = 0.774, p = .379, or for all patients during FT hours, F (1, 2647) = 1.1, p = .295. The results of the study support the belief that rapid evaluation and disposition of low-acuity patients improve ED efficiency and reduce ED crowding.

Format

PDF

Language

English

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