When Technology Hinders Patient Flow and Satisfaction

Purpose:
The purpose of the poster presentation is to exhibit a rapid Quality Improvement project that involved discontinuing the usage of an electronic bed system and reinstituting a process of direct nurse to nurse communication. The poster will highlight improved outcomes that resulted from the project.

Significance:
The patient experience frequently starts in the ED. With Value Based Purchasing, patient satisfaction is crucial. Additionally, efficient workflows are essential for providing emergency care in a growing population of healthcare consumers. Finally, patients must remain at the center of healthcare.

Strategy and Implementation:
January 2011, an electronic bed management system was implemented. The new process of bed assignment became more complex. First, the nurse would be notified of receiving a patient. At the nurse's convenience, she would log into a computer and assign a bed based on limited information. Transferring staff periodically checked the bed system to review the bed status. This process was mainly nurse focused and was dependent on the nurse's needs. Staff expressed concerns about the bed system immediately. After several months, leadership assessed the effectiveness of the system by analyzing data and conducting an employee survey. The survey revealed staff felt vital information was being lost while transferring patients. A decision was made to return to the previous method by the end of 2011. The final process involved Charge Nurses directly collaborating to make bed assignments based on patient needs. The process became patient centered once again.

Evaluation:
Time from admit order to inpatient assignment reduced from 10.9 to 2.2 minutes. Time from admit order to leaving the ED went from 94.1 to 38.2 minutes. ED length of stay decreased 175 to 152 minutes, below the 261 minute national benchmark. Patient satisfaction improved from 46% to above the 90%.

Implications for Practice:
Utilizing technology to improve patient care is a current healthcare trend. Using technology does not guarantee improved outcomes. Leadership should carefully consider process before implementing new technologies. The patient should always remain at the center of the healthcare workflow.