Be realistic with time, costs of ED strategies

Some emergency department (ED) strategies are more costly and time-intensive than others that hospitals should consider carefully, according to new research from the Emergency Nurses Association.

A study, published in the September Journal of Emergency Nursing, looked at six "Urgent Matters" hospitals, an initiative by the Center for Health Care Quality at The George Washington University Medical Center aimed at curbing ED overcrowding. Researchers found that implementing ED flow strategies, usually nurse-led, ranged anywhere from $32,850 to $490,000 for the most sizable expenditures. And the time spent planning and implementing those strategies also varied highly, from of a 40-hour workweek to 1,017 hours per strategy.

With wide variations and multiple ED strategies to choose from, "hospital, ED and nurse leaders should set realistic expectations for the time and expenses needed to support patient flow improvement," study authors said.

Even with the associated costs of improving patient flow, can hospitals afford not to invest time and money?

For instance, The Wall Street Journal reported in an article yesterday that once accepted treatment guidelines for emergency heart patients may be outdated. Every minute counts in the "door-to-balloon" time to get the patient into the cardiac catheterization lab for an angioplasty, the newspaper reported.

"Hospitals must view patient flow as a facility-wide concern and should allocate sufficient resources, including appropriate ancillary services and nurse staffing, to ensure the delivery of timely, safe and effective patient care," the Emergency Nurses Association said in a position paper on improving throughput.

For more information:
- see the study abstract
- check out the Urgent Matters toolkit
- read the ENA position paper (.pdf)
- here's the WSJ article

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