Immediate communication at the time of handoffs can greatly decrease the time a patient has to wait in the ED. When an ED nurse has a patient ready for admission, they are still juggling their other emergent patients. There needs to be a simple and prompt method to quickly move the patients to the floor and give report.
The challenge is when admitting departments are not able to take the report. The units frequently say “we will call back”, but when they do, the ED nurse is with another patient and can't take the call. This results in several hours of phone tag. You wouldn't tolerate a rescue squad not providing a report when bringing a patient in, so why is it tolerated among departments? The Advanced Emergency Nursing Journal recommends no-delay nurse reports. "No-delay nurse reports reduce time from admit orders to arrival on inpatient units, decrease the potential for handoff errors (because they ensure that both the ED and inpatient nurses have the same information), and increase patients' perception of care due to timely transfer of care."2
The ED is often filled with emergent patients who are waiting because they simply can't get an inpatient bed. It doesn’t have to be this way though. Boarding can be significantly reduced using the three key strategies of Anticipation, Elimination of Batching, and Communication on Handoffs.
P.S. Once you have applied those strategies in your ED, don’t forget that patient flow and progression strategies applied out on your inpatient units can have a huge impact on your ED throughput. I’ve seen hospitals cut ED holds by almost 50% with these strategies.
For more information on reducing ED holds and improving patient progression in your hospital, visit www.carelogistics.com.