Jason Kaufman, RN, director of emergency services at 320-bed St. Francis Hospital in Indianapolis, explains how the St. Francis ED reduced its "lost without being seen" rate, enhancing patients safety and revenues.
Problem. Patients checking in at the ED waiting room sometimes had to wait 15-20 minutes to be seen by one of two triage nurses inside the ED when they were backed up seeing other patients. In that time, a patient could have a serious medical problem or walk away, depriving the hospital of revenue from treatment and, in some cases, admission into the hospital.
Solution. One triage nurse is stationed at the front desk to implement "rapid triages" for everyone at time of check-in. They are then sent back to the second triage nurse for a comprehensive triage. If the comprehensive triage nurse has three or more patients waiting, the ED charge nurse or a nurse from the exam area is summoned to care for some of these patients.
Outcome. Since the change was implemented about a year ago, the ED's "lost without being seen" rate, the percentage of patients who checked in but left without being seen by a triage nurse, fell from 2 percent to 1 percent, resulting in an estimated $500,000 in extra revenue for the hospital.
Further action. A third nurse is not available when the ED is very busy. The hospital is considering hiring an emergency medical technician or certified nurse assistant to help with rapid triages before an RN sees the patient.
Learn more about St. Francis Hospital.
Read other coverage on ED overcrowding.
- 6 Reasons Why Healthcare Reform Won't Reduce ED Overcrowding
Problem. Patients checking in at the ED waiting room sometimes had to wait 15-20 minutes to be seen by one of two triage nurses inside the ED when they were backed up seeing other patients. In that time, a patient could have a serious medical problem or walk away, depriving the hospital of revenue from treatment and, in some cases, admission into the hospital.
Solution. One triage nurse is stationed at the front desk to implement "rapid triages" for everyone at time of check-in. They are then sent back to the second triage nurse for a comprehensive triage. If the comprehensive triage nurse has three or more patients waiting, the ED charge nurse or a nurse from the exam area is summoned to care for some of these patients.
Outcome. Since the change was implemented about a year ago, the ED's "lost without being seen" rate, the percentage of patients who checked in but left without being seen by a triage nurse, fell from 2 percent to 1 percent, resulting in an estimated $500,000 in extra revenue for the hospital.
Further action. A third nurse is not available when the ED is very busy. The hospital is considering hiring an emergency medical technician or certified nurse assistant to help with rapid triages before an RN sees the patient.
Learn more about St. Francis Hospital.
Read other coverage on ED overcrowding.
- 6 Reasons Why Healthcare Reform Won't Reduce ED Overcrowding