Want to see teamwork in action? Just pay a visit to TriStar Greenview’s Emergency Department.

It’s a team that has faced many challenges over the past two years. They have been working hard to address and improve patient throughput and the potential for emergency department overcrowding, in conjunction with the initiative undertaken to reduce ER wait times throughout the HCA TriStar division.

Karen Ellis, RN, Director of Emergency Services, says proudly of her team, “The thing that comes to mind is how much of an impact our new process has made to quick turnaround times, including arrival to room placement and initial contact time with an ER doctor. It is the improvement in patient and staff satisfaction that rings out loudly every day.”

“Patients get through the process of a visit with a shorter stay in the ER, to be ultimately discharged or admitted to their room in house. The staff has a real sense of satisfaction on the job with the visible changes we have made.”

By implementing LEAN principles of process improvement, unit leaders and staff created a smoother process.

• When a patient arrives at the ED, they are taken immediately to an open bed, when available, and many times are seen by the physician upon arrival to a room.
• The triage and registration processes are completed at the bedside decreasing wait times for paperwork completion. 
• The goal is for patients being admitted to the hospital from the ED to be in their inpatient room within 30 minutes of receiving the room number and admission order. 

Average time from arrival-to being seen by an physician, physician’s assistant or nurse practitioner has decreased nearly 50% to an average of 25 minutes in 2010 as compared to 2009.

Average length of stay in the ED decreased by 20% in 2010 as compared to 2009.

The success of streamlining the process is evident, as staff retention rate and patient and staff satisfaction scores were higher in 2010 than in 2009 and staff turnover was lower in 2010 than in 2009.

Chief Nursing Officer Anne Leonard, RN, MBA, salutes the nursing team by saying, “Our nurses own this initiative and the positive outcomes that have resulted. We have maintained these improvements for two years now, with no more space and an increase in ED visits.”