Abstract
Background: Inefficient emergency department to inpatient handoff processes can contribute to delayed care.
Local Problem: The average emergency department length of stay for admitted patients and admission wait times at this institution were well above national averages, and a standard handoff process was lacking.
Methods: Lean methodology was used to evaluate flow and identify opportunities for improvement.
Interventions: Two tools were developed to standardize handoff.
Results: Emergency department length of stay and admission wait times were not significantly improved following intervention implementation. However, patient transfer time decreased significantly (P < .01, F = 29.02) from 30.5 minutes (SD = 18.2) to 21.7 minutes (SD = 7.4). The length of time to give/receive report also decreased significantly (P = .04, F = 2.2) from 3.8 (SD = 1.6) minutes to 2.8 (SD = 1.2) minutes.
Conclusions: Although length of stay and admission wait times did not decline significantly, implementation of standard work and tools can potentially improve patient flow.