Time, Cost of Plans to Improve Patient Flow in the ER Vary

Adoption of strategies designed to improve overcrowding mainly led by nurses

THURSDAY, Nov. 8 (HealthDay News) -- Adoption of patient flow improvement strategies designed to reduce emergency department overcrowding involve a variable amount of time and expenditure, with nurses playing a key role in planning and implementing strategies, according to research published in the September issue of the Journal of Emergency Nursing.

Megan McHugh, Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the time and expenses associated with implementation of patient flow improvement strategies to reduce emergency department overcrowding. One hundred twenty-nine informant interviews with members of the hospitals' patient flow improvement team in six Urgent Matters hospitals were conducted immediately after strategy implementation and about six months later.

The researchers found that eight strategies were implemented. Per strategy, the time spent on planning and implementation ranged from 40 to 1,017 hours. The strategies were primarily led by nurses, and more time was spent on planning and implementation by nurses than others. Strategies that involved extensive staff training, large implementation teams, or complex changes in process were the most time consuming. Sizable expenditure was involved in three strategies and ranged from $32,850 to $490,000. The most costly expenditures were construction and addition of new personnel.

"This study provides important preliminary data on the time and expenses involved in the adoption of patient flow improvement strategies and lessons learned from the experience of six hospital teams," the authors write. "Our results may offer guidance to hospital and department leaders and nurses on setting appropriate expectations for the time and expenses associated with implementation."

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