Date of Graduation

Fall 12-12-2014

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

First Advisor

Juli Maxworthy DNP, MSN, MBA, RN, CNL, CPHQ, CPPS, CHSE

Second Advisor

Jason H. Bell, M.D., Ph.D., F.A.C.S.

Third Advisor

Steve Feagins, M.D., MBA, FACP

Abstract

The purpose of this project was to evaluate the patient experience in the emergency department (ED) and in the inpatient setting while correlating increased throughput and patient outcomes at a suburban Acute Care facility in Ohio. The culture in the organization has lacked accountability and ownership of the patients. The ED admitted length of stay (ALOS) was 358 minutes in the beginning of 2013. For the first time in the organization’s history, the ED ALOS is now typically less than the recommended benchmark of 300 minutes. A report of findings among ED’s surveyed showed the ALOS best practice is 244 minutes with a median length of stay of 309 minutes (Premier, 2006, slide 13). Throughout its recent history, the organization has failed to have a service-oriented approach to patient care. Quality improvement was identified and implemented through a hospital-wide Kaizen event focused on throughput of the admitted patient (Appendix A). According to King (2010), “the Japanese words Kai and Zen literally means “to change” and “for the better”, and it has come to symbolize continuous improvement” (slide 5). Teams of individuals ranging from physicians to transporters spent one week of work time focused on the process mapping of the current state and future state of ED throughput. The use of information technology (IT) in the process improvement was integral to performance improvement, patient safety, and consistent ED ALOS less than 300 minutes. The transformation of the culture has aided in the success of maintaining patient throughput