Date of Graduation
Summer 8-8-2025
Document Access
Project/Capstone - Global access
Degree Name
Master of Science in Nursing (MSN)
College/School
School of Nursing and Health Professions
First Advisor
Dr. David Ainsworth
Abstract
Abstract
Background: This quality improvement project aims to reduce the process time for transferring non-members from the emergency department to another acute hospital, thereby decreasing the admission day rate.
Problem: The medical center's Emergency Department (ED) has experienced a significant increase in patient visits over the past five years, particularly since the COVID-19 pandemic. This increase includes non-members from other health plans, leading to high demand for specialty beds. The current process of transferring stable non-members to community hospitals is inefficient, taking 5-6 hours, with the goal of reducing this to 4 hours. The quality improvement project focuses on enhancing communication and workflow among healthcare teams to optimize the transfer process and improve patient care and satisfaction.
Interventions: Team members planned the execution of the non-member transfer process, discussing changes and interventions. They aimed to reduce transfer time from 6 to under 4 hours by improving communication and workflow. The average cost of an ED visit is $750 per hour, with potential annual savings of $360,000 if the transfer time is reduced. Training costs $5,770, leading to net savings of $354,230.
Outcome Measures: Manual data from huddles indicated that nurse awareness of non-member identification increased from 20% to 80%. The goal was to reduce the non-member transfer process time from 4-6 hours to 4 hours. The data from December 20204 to June 2025 showed that the average baseline transfer time was 5 hours for all these months.
Results: Post-intervention results showed an increase in nurses’ awareness of the transfer process from 20% to 80%. The transfer process time remains the same as the baseline of 5 hrs. This failure to meet outcome goals was due to the assigned community hospital's inability to accept non-members, influenced by new leadership decisions, and the lack of other contracted hospitals for non-member transfers.
Conclusion: Optimizing the non-member transfer process was unsuccessful due to unforeseen obstacles arising from the new leadership of the accepting facility. The next step is to hand off to the inpatient care coordinator to continue looking for appropriate community beds and transfer non-members from inpatient units.
Keywords: Transfer patients from the ED, Interfacility transfer, and intrahospital transfer.
Recommended Citation
Kaur, Simarjeet Ms., "Optimizing Non-member Transfer Process" (2025). Master's Projects and Capstones. 1911.
https://repository.usfca.edu/capstone/1911
