Reducing time to X-ray in emergency department ambulatory patients: a quality improvement project.

Autor:	Kwok MMK; Department of Emergency Medicine, Richmond Hospital, Vancouver Coastal Health, Richmond, British Columbia, Canada Matthew.kwok@vch.ca.; Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.; Physician Led Quality Improvement, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada., Chiu A; Physician Led Quality Improvement, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada., Chia J; Team Based Quality Improvement, Vancouver Coastal Health, Vancouver, British Columbia, Canada., Hansen C; Department of Emergency Medicine, Richmond Hospital, Vancouver Coastal Health, Richmond, British Columbia, Canada.; Team Based Quality Improvement, Vancouver Coastal Health, Vancouver, British Columbia, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2021 Apr; Vol. 10 (2).
DOI:	10.1136/bmjoq-2020-000995
Abstrakt:	This quality improvement project began when physicians and nurses at our hospital observed patients waiting for excessive periods of time for a porter to escort patients from the emergency department (ED) to medical imaging (MI). However, certain patients may not need staff escort and are able to ambulate from ED to MI by themselves. This would reduce waiting time from when the X-ray is ordered to X-ray being done, which may reduce overall ED length of stay and improve patients' experience.Our project aim is to decrease the time to X-ray by 50% within 6 months by having appropriate ambulatory patients walk from the ED to the X-ray department without a porter. To achieve our goal, several strategies were employed. First, brainstorm sessions were held to better understand the barriers and ways to implement the new process. Second, a patient survey was conducted to understand their thoughts on the change idea. Third, data were collected to assess the inefficiency problem on the number of times non-porter staff escorted patients due to porters being unavailable. A total of 14 PDSA (Plan-Do-Study-Act) cycles were completed between December 2018 and May 2019. A human factor specialist was consulted to examine the process for safety and optimisation of the patient journey.In our PDSA cycles, self-ambulatory patients were compared with ambulatory patients who required an escort. An improvement was found from time to X-ray of 28 min (11 min vs 39 min). The new self-ambulatory process was implemented in June 2019 on a daily basis. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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