Improving Triage and Patient Throughput Process With Emergency Department Rapid Triage Protocol and Emergency Severity Index Training
Objectives: This project aims to decrease Admission to Physician Times (ATP) to less than 30 minutes and reduce the rate of patients who leave the emergency department without being seen (LWBS) to less than 10%. By implementing an evidence-based emergency department rapid triage protocol (EDRTP), the project will decrease the length of stay/arrival to discharge (ATD) for patients with Emergency Severity Index (ESI) 4 and 5 to less than 2.5 hours. Additionally, the DNP project lead created an EDRTP oversight committee for a continuous assessment and evaluation of the EDRTP. Methods: The project integrated quantitative methods to determine and measure the effectiveness of EDRTP and ESI training for the emergency department and staff. This task was completed with a multi-method approach, including pre-and post-training evaluation tools to assess ED staff knowledge, confidence, and beliefs about ESI Triage and EDRTP. The DNP project lead analyzed all data retrieved and collected. Results: The DNP project outcomes produced up-to-date and evidence-based triage knowledge and skills. The EDRTP and ESI training resulted in a significant decrease in ATP, ATD (ESI level 4&5), and LWBS rates. All DNP project objectives were met. Conclusion: This DNP project demonstrates that emergency department leaders and staff recognize Emergency Severity Index (ESI) Triage and Emergency Department Triage Protocol to be a valuable change of practice to their current department workflow. Additionally, this project prepared nurses to identify and prioritize patients who required urgent interventions while improving the ATP times, LWBS rates, and length of stay for patients with ESI levels 4 and 5.
Submitted in partial fulfillment of the requirements for the degree Doctor of Nursing Practice