Improving ED patient flow

A simple repurposing of an existing role in our Emergency Department is helping patients receive the care they need more quickly.

Acting Executive Director of Patient Flow and Reform, Kate Brockman says improving patient flow through the ED was one of the key ways to improve patient flow throughout the entire health service and to improve patient outcomes.

"The literature shows the longer you spend in a crowded ED the worse your outcomes are likely to be,'' Ms Brockman explained.

"One of the key roles that we identified that would help with ED flow is the ANUM role," she said.

"We have repurposed an existing role so that rather than having four people in ED managing patient flow in isolation, we now have an ANUM acting as a global coordinator of patient flow. Their role is to manage key steps of the patient journey and support timely decision-making in the context of the next steps for that patient.''

Since the change was introduced in December 2017 we have seen an improvement in our ability to reach NEAT targets (90% of ambulance offloads within 40 minutes and 80% of patients through the department in under 4 hours).

Ms Brockman says a raft of other possible flow improvements have also been identified since the initiative was introduced.

She says strengthening communication channels between ED and the rest of the hospital through daily huddles is also resulting in positive change for patient flow.

Neely Pratten led the implementation of the new role and is one of the ANUMs who works in the position. She says the change has resulted in a more effective work process.

"Now I don't get involved in any of the clinical aspects of the floor. I'm solely focused on the flow," Ms Pratten explains.

"It's my job to see why the blockages are there and get rid of them so we get the person through."

"Now that we have this position established we are starting to engage with other senior nurses in the tower so we can get that hospital coordinated response''.

Ms Pratten says it is important that all staff regard ED patients as Austin Health patients rather than ‘ED patients' and focus on getting them up to the wards as quickly as possible to get the correct treatment for their complex care needs earlier.

Ms Brockman says improving patient access to services not a challenge that is unique to Austin Health.

She says people are continuing to arrive at EDs across health services in increasing numbers and with limited resources it was important to be proactive and think of new ways to do things more efficiently.

She says staff in ED have embraced the latest initiative and encouraged all staff who identify opportunities to improve patient flow across the health service to put their thoughts forward.

If you have any ideas on how to improve efficiency and flow please contact Patient Flow and Reform manager Kath Wilson on EXT 3221.