Completing accelerated requests in the emergency department (CARED For)

Abstract

Emergency Department (ED) throughput is a complex and multi-faceted problem affecting EDs nationwide. Since the passing of the Affordable Care Act (ACA) in 2010, ED patient volumes have been increasing (Lin et al., 2018). These increased volumes have led to longer wait times, decreased patient satisfaction, and increased patients that are either leaving against medical advice, or without being seen (Salway et al., 2017). One potential intervention that could improve ED throughput is the utilization of a Provider in Triage (PIT). Use of a PIT has the potential to reduce door to provider times, left without being seen rates, and provides an opportunity to identify potential serious medical conditions while patients are waiting more quickly for treatment. This quality improvement project was directed at implementing a PIT role in a university-based ED that had not previously successfully utilized a PIT previously. After one month of use, the ED saw greater than 50% decrease in patients that left without being seen. While no other throughput factors were statistically significant for change, the clinical significance of the project has proven to be beneficial and PIT has been implemented as an ongoing intervention in the ED.