Poster Presentation
Friday, 21 July 2006
10:00 AM - 10:30 AM
Friday, 21 July 2006
3:00 PM - 3:30 PM
29 Minutes from Arrival to Physician in Pediatric Emergency Department: Initiating System-Wide Change
Florence Nezamis, RN, BS, MSA, Nursing Administration, Children's Hospital of Michigan, Detroit, MI, USA
| Learning Objective #1: Describe two challenges in implementing a system-wide change such as the 29 Minute initiative. |
| Learning Objective #2: Describe two positive outcomes of the ED 29 Minute initiative. |
In 2004 the Detroit Medical Center began a system-wide change in each of their facilities to decrease the long waits that families often experienced in their Emergency departments. This program, known as the 29 Minute Initiative, guarantees patients that they will be seen by a physician or nurse practitioner within 29 minutes of arrival in the ED. This presentation will focus on the implementation of this large-scale performance improvement initiative in a large urban children’s emergency department: a process that involves multiple departments, units and services throughout the institution as well as an aggressive marketing campaign. Nursing has played a key role in this initiative which involved a number of changes, such as: increasing number of ED beds, wireless environment, bedside registration in the ED, and an aggressive focus on discharge process hospital wide. Although challenging, this initiative has shown positive results. In 2004, the Left Without Being Seen (LWBS) rate was 2.15%. “Go Live” of 29 Minute Initiative occurred in February of 2005. We chose the 3 summer months, which are typically lower volume months, for points of reference to evaluate the effects of this initiative. In June through August of 2004 the mean LOS was 163 minutes while in the same period in 2005, LOS dropped to 124 minutes; a 24% change. LWBS in 2005 dropped to 0.74%, a 1.41% change. In the same three summer months, the number of visits increased by 16% in 2005. In August of 2004, 66% of children were seen in 29 minutes, while in August of 2005, this number was 99%. This presentation will detail the challenges experienced by nursing in the implementation process and the need for multidisciplinary collaboration in initiating system-wide change.
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