Acute unscheduled care in seven developed nations
Philips has sponsored an in-depth assessment of acute unscheduled care, the demands on acute care providers, and use of the emergency department across 7 countries. This research paper explores the similarities and differences in the factors leading to acute unscheduled care demands, care decision making, and care delivery in the ED and beyond.
To understand the organization’s concerns, an in-depth assessment of the department was performed. Interviews with staff members, administrators and other departments that interface with the ED were held. The assessment team completed direct observation of patient flow processes and reviewed related data. The two major areas of opportunity identified were the revision of front-end processes and the realignment of staffing resources away from a serial model of care.
Information obtained from ED staff and hospital leadership along with the Philips Blue Jay Consulting assessment team provided the foundation for the project “work teams”. Each of the teams had designated co-leaders (a physician and a nurse) and was facilitated by the onsite consultants.
Team membership came from all of the disciplines that work in the ED. In this multi-disciplinary model for performance improvement, thirty-seven ED staff members participated in the work to discuss, design and implement solutions to positively impact patient care and flow. In addition the team members and the department leaders kept their colleagues informed about the work of the teams and brought staff input back to the teams.
During the 6 month project the work teams focused on the design and implementation of the following solutions:
• Greeting by an RN on arrival
• Rapid triage with streamlined documentation requirements
• Immediate bedding whenever a treatment space was available
• Redefined components of quick registration
• Geographically assigned care teams composed of providers, nurses and techs
• Providers and nurses seeing patients together
Bill is a dynamic and talented nurse leader with over 30 years of experience in emergency care and patient flow. In his most recent roles, facilitating performance improvement and in interim leadership positions, he has successfully developed client relationships and effectively mentored other nurse leaders to improve operations within their departments. Bill excels at assessing client operations in order to identify opportunities for improved patient flow and service.
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