Medicine and Health Sciences Commons^™

Improving The Workflow And Partnership Between Registration And Clinical Staff In An Outpatient Urgent Care Center, Melissa Fairfield, Bailey Eells, Faye Collins, Joyce Cornish, Stephen Tyzik, Joy Moody, Wendy Osgood, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

An outpatient urgent care unit was experiencing challenges in balancing the need to register patients and delivering care in the timeliest manner as possible. Upon examination, it was found that delays were being experienced in patient triage and discharge that resulted in low patient satisfaction scores.

A team of providers was established to review all process steps and a quality improvement project was created to attain a goal of 100% of the time discharge would not be delayed due to incomplete registration.

Baseline metrics demonstrated current numbers of delayed discharges, median time from door to triage as well as door …

Increasing Access To Spiritual Care Services In The Emergency Department: A Patient And Staff Support Model, Heather Weidemann, Tia Jamir, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operational Transformation

In trauma centers, there is evidence that interfaith spiritual care reduces emotional distress and improves health outcomes. In order to be effective in providing timely support, chaplains must be integrated into the clinical care team.

In an academic tertiary medical care center, a spiritual care team felt there were numerous missed opportunities to offer support to ED patients and its staff due to lack of being part of the care team. As a result, a performance improvement project was developed with the overall goal of integrating spiritual care into the ED clinical setting.

Baseline metrics and a root cause analysis …

Outpatient Treatment Of Pulmonary Embolism: A Single-Center Case Series, Annie Huyler, Casey Z. Macvane, Andrew Perron, Tania D Strout

Maine Medical Center

Background: Pulmonary embolus (PE) is associated with significant utilization of health care resources and financial burden Several additions that have allowed us to look at safely treating patients with PEs as outpatients:

• Simplified Pulmonary Embolism Severity Index (sPESI) -Risk stratifies patients based on their age, vital signs, and past medical history

• Novel oral anticoagulants

Primary Objective: To describe the population, treatment strategies, short-term complications and outcomes associated with outpatient management of PE following treatment in the ED.

Seerratus Anterior Plane Block (Sapb) Improves Paine Control In Rib Fractures, Randy Kring, Peter Croft, David Mackenzie, Christina Wilson, Joseph Rappold, Tania D. Strout

Maine Medical Center

Background:

•Trauma is a major cause of morbidity and mortality worldwide. Rib fractures are identified in at least 10% of all injured patients.

•Rib fractures can lead to significant respiratory complications, with pneumonia and respiratory failure occurring in up to 31% of patients with rib fractures. Early initiation of aggressive pain control and pulmonary hygiene with incentive spirometry are standard of care to prevent complications from developing.

•In the Emergency Department, patients with rib fractures typically receive systemic analgesia that is largely narcotic-based. This pain control strategy puts patients at risk for the side effects of narcotics such as constipation, …

Reducing Length Of Stay For Mental Health Patients, Faye Collins, Nancijean Goudey

Maine Medical Center

Background:

Our facility sees an average of over 200 mental health patients every month, with limited community resources. The length of stay (LOS) for these patients had slowly risen to unacceptable levels; the number of patients whose LOS was greater than 24 hours increased in fiscal year (FY) 2017, from 633 patients to 1145. Patients in crisis require expedited transfer to appropriate care locations. Our goal was to decrease the overall length of stay for mental health patients in the Emergency Department.

Improving Safe Handoffs & Transitions From The Ed To Adult Inpatient: A Response To The Ahrq Hospital Patient Safety Culture Survey, Natalie Talbot, Joanne Chapman, Rhonda Diphilippo, Gail Savage, Michele Higgins, Nancijean Goudey, Lori Sweatt, Erin Graydon Baker, Joseph East, Stephen Tyzik, Suneela Nayak, Mark Parker, Ruth Hanselman, Amy Sparks

Operational Transformation

SAFE TRANSITIONS AND PATIENT HANDOFFS IN A LARGE ACUTE CARE HOSPITAL

It is well documented in the literature that ineffective patient handoffs and transitions continues to be an area that can lead to adverse patient safety events so it is an urgent opportunity for a performance improvement plan. At an academic tertiary care medical center, the lowest scoring domain from the FY2017 AHRQ Patient Safety Culture Survey was patient handoffs and transitions.

A team was established consisting of staff from the Emergency Department and a medical/surgical unit to develop a plan for implementing improvement interventions. Their goal was to attain …

Patient Throughput Time In The Emergency Department: Can Obtaining Blood Specimens In A Pre-Hospital Setting Increase Timeliness?, Arielle Rancourt

Interprofessional Research and Innovations Council

Patient Throughput Time in the Emergency Department:

Can Obtaining Blood Specimens in a Pre-hospital Setting Increase Timeliness?

Arielle Rancourt RN

Abstract

The Emergency Department (ED) at Mid Coast Hospital currently follows a practice in obtaining blood specimens in-hospital by emergency department staff; this is done despite the ability of pre-hospital personnel to obtain specimens at the time of intravenous catheter insertions. Our current practice may not be the most effective and timely method. Studies showed that there was no increase in hemolysis of blood specimens drawn by Emergency Medical Services (EMS), and that laboratory results were received quicker when blood …

Statistical Forecasting Models Used To Predict Daily Patient Volumes In The Emergency Department: A Proposal For A Systematic Review, Jon White

Interprofessional Research and Innovations Council

Statistical Forecasting Models Used to Predict Daily Patient Volumes in the Emergency Department: A Proposal for a Systematic Review

Jon White, MS, BSN, RN, CCRN

Background: The existing and projected worldwide shortage of nurses requires numerous distinct solutions to prevent a healthcare crisis. Proposed solutions typically address the situation from different angles, including identifying ways to add new nurses to the workforce, or finding new ways to work with limited resources. This review examines the efficacy of forecasting demand in one area of the hospital, understanding the potential of its uses for short-term resource balancing and projection of need.

This …

Patient Throughput Time In The Emergency Department: Can Obtaining Blood Specimens In A Pre-Hospital Setting Increase Timeliness?, Arielle Rancourt

Interprofessional Research and Innovations Council

The Emergency Department (ED) at Mid Coast Hospital currently follows a practice in obtaining blood specimens in-hospital by emergency department staff; this is done despite the ability of pre-hospital personnel to obtain specimens at the time of intravenous catheter insertions. Our current practice may not be the most effective and timely method. Studies showed that there was no increase in hemolysis of blood specimens drawn by Emergency Medical Services (EMS), and that laboratory results were received quicker when blood specimens were obtained in a pre-hospital setting. The purpose of this quality improvement project is to decrease time from patient arrival …

Statistical Forecasting Models Used To Predict Daily Patient Volumes In The Emergency Department: A Proposal For A Systematic Review, Jon White

Interprofessional Research and Innovations Council

Background: The existing and projected worldwide shortage of nurses requires numerous distinct solutions to prevent a healthcare crisis. Proposed solutions typically address the situation from different angles, including identifying ways to add new nurses to the workforce, or finding new ways to work with limited resources. This review examines the efficacy of forecasting demand in one area of the hospital, understanding the potential of its uses for short-term resource balancing and projection of need.

This systematic review will provide a current synopsis of the research published since the fall of 2007, expanding on Wargon and colleagues’ A systematic review of …