Improving Patient Throughput in the Emergency Department Essay

2929 WordsNov 13, 201212 Pages
Improving Patient Throughput In the Emergency Department Introduction St. Vincent’s Medical Center, a 501 bed facility located in Jacksonville, Florida, provides general medical and surgical care to the North Florida Region. St. Vincent’s admits over 26,000 patients annually. The average occupancy rate is approximately 84% with the Emergency Department (ED) peeking at 100% for approximately 4-12 hours daily. The hospital is struggling with availability of bed space. This shortage of available beds creates a bottleneck in the ED on high census days. Bottlenecks are created in the ED when there is a shortage of inpatient beds to place admitted ED patients. Thus, patient flow, or throughput, is becoming more and more important.…show more content…
Patients arriving in the ED are triaged by a nurse then placed in an ED room according to their acuity. After being evaluated by a physician, the patient is either released to home or admitted. When the decision is made for the patient to be admitted, a request for an inpatient bed is placed to nursing administration who then assigns an available bed. If there is not an appropriate bed available, the patient must remain in the ED bed. This effectively reduces the capacity of the ED causing the department to either divert patients or patients will leave without being seen. Every patient who is diverted or leaves without being seen is lost opportunity cost to the hospital. Patient Volumes Patient volumes vary greatly in the ED. There are, however, patterns noted in census fluctuations according to the day of the week. High census days are historically early in the week, while lower census usually occurs later in the week. On days when the census is high throughout the hospital, there will be patients holding in the ED awaiting inpatient beds. The following graph depicts the number of patients holding in the ED by month during the past fiscal year. This graph depicts the total ED volume by month for the past fiscal year. Step 2: Develop Criteria Feasibility Criteria: 1. Maintain Current Budget The budget for this project will be based off of excess funding from the department. Due to the budget for current fiscal year and the next
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