Emergency Department

(December 2017 reporting is based on different discharge periods between January of 2016 and March of 2017 depending on the measure)

More recent data is also available reporting discharges from January-December 2017.


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Created new Rapid Assessment Team for faster triage; team educated on visual metrics (Computer Tracking System) with emphasis on patient status changes. When at capacity, the hospital ensures that ED or Inpatient Nurses are responsible for providing care for all patients that are boarding in the ER (waiting for an Inpatient bed).  NBH has begun construction on a brand new ED providing 28 beds; which will be completed in December 2017. Phase 2 will provide an additional 15 bed observation unit that will provide more flexibility to Inpatient admissions. A throughput committee has been developed to reduce ED times. Also, a ZIP process has been newly implemented to move patients with specific symptoms from the ED to the hospital floors and reduce waiting times. A team is also being led by the Director of Nursing to improve hospital-wide turnaround times. Created admission units to move patients out of the ED to increase patient flow Implementation of bridge orders by ED physicians. Teletracking monitoring and updating attribute forms in a timely manner. Admission orders are initiated within one hour of patient's status change to inpatient. The ED team has been educated on Visual Metrics (Computer Tracking System);patient status changes are reviewed to optimize patient throughput. When at capacity, the hospital ensures that ED or Inpatient Nurses are responsible for providing care for all patients that are boarding in the ER (waiting for an Inpatient bed). NBH is currently under construction building a brand new ED providing 28 beds; which will be completed in December 2017. Phase 2 will provide an additional 15 bed observation unit that will provide more flexibility to Inpatient admissions; which is planned for completion in May 2018. Created admission units to move patients out of the ED to increase patient flow. Teletracking monitoring and updating attribute forms in a timely manner. Hospital wide plan to implement an admission holding unit for patients waiting for a bed. The Rapid Assessment Team addresses patient triage more quickly. A Fast Track Area provides additional access for patients and to improve patient flow. Daily nursing communication & education; P.A. in Triage to initiate orders. Patients treated 'vertically' in waiting room as appropriate. ED Expansion will be finalized within 2 weeks. Daily reporting of throughput measures within department. New ED will have a new results pending area for lower acuity patients. Positions have been opened to staff a 4 bed admission unit, which will free up additional ER beds for patient evaluation and treatment. Additional medical staff hours have been added. The charge nurse role has been modified to allow more time to address ER volume. Created admission units to move patients out of the ED to increase patient flow. Implementation of direct bedding and vertical bed area. Education of team members to remove patients from tracking board in a timely manner. ED coordinator monitors discharge orders. Implemented new Smart Track model with physician present in triage. Times are tracked and presented daily to the team as well as Administration. Emergency Department is in final stage of facility update/expansion for improved flow. Patients bypass the triage area and placed directly into the patient care area whenever open beds are available. Lower acuity patients triaged and seen quicker using a designated Reporting daily metrics on key quality measures. Physician staffing has been increased. Positions have been opened to staff a 4 bed admission unit, which will free up additional ER beds for patient evaluation and treatment. Additional medical staff hours have been added. The charge nurse role has been modified to allow more time to address ER volume. Created admission units to move patients out of the ED to increase patient flow Implemented a direct bedding process where staff move patients to treatment rooms as soon as possible, which may include doing registration at the patient's bed. Implementation of direct bedding and vertical bed area. New protocol implemented for Triage Nurse in coordination with the Triage Physician, to administer pain medication as soon as seen in Triage. Triage to work on process to identify patients with broken bones and notify PA so pain medication can be ordered. Daily metrics are being reported and initiative to decrease door to doc time is in effect. Patients are asked if they want pain medication: if yes, patient receives the ordered medication within 30 minutes of arrival. If no, documentation of refusal is entered in the chart. Implemented triage protocols to address pain management and improve patient throughput. Implemented a direct bedding process to get the patient to doctor in a timely manner. A new pre-hospital stroke alert process has recently been implemented.  Emergency Medical Service (EMS) providers provide notification when a stroke is recognized in the field.  Upon hospital arrival, a rapid assessment by the ED physician is preformed, and if appropriate, the patient  is transported directly to the CT scanner, bypassing the ED bed,  for initial neurologic examination and brain imaging.