Emergency Department (ED) wait times are a challenge for hospitals everywhere. When Kenmore Mercy Hospital assembled an interdisciplinary team to improve their ED triage times, their goal was to have 95% or greater compliance with an Emergency Severity Index (ESI) level assignment within 20 minutes of arrival for ambulatory patients.
The team identified variations in the process due to different shifts and staffing patterns, and as a solution, they developed and introduced a new “pivot nurse” role to the triage process. Within 20 minutes of the patient’s arrival, the trained, clinical pivot nurse performs an initial assessment using the ESI and quickly determines if immediate intervention is needed. This screening ensures that every patient is seen according to the type and urgency of their condition.
With the addition of the new role, there has been a monthly compliance rate of 97% or greater for patients being assigned an ESI level within 20 minutes. The average time from door to ESI for ambulatory patients has decreased from 18.3 minutes to 6.6 minutes. The patient experience question for timely ED check-in improved from 57.45% to 64.35%.