'Bed Wizards' Transform ED Throughput

The role allows the ED to assess patients once and get them in a bed. Before the wizard, each patient was assessed by the primary nurse, with a secondary assessment when they reached their beds, which took about 20-30 minutes.

“Why are we doing that when we could direct bed them?” says Lane. “The first person they see is a registered nurse. The triage nurse talks to them and does an assessment. If we have a bed open, they now go to a bed, whereas before they did not.”

Other changes include sending patients immediately for x-ray and having a phlebotomist at triage who can start lab work. All these initiatives have dramatically reduced patient wait times, which increase satisfaction.

“In the departments where flow facilitators have been implemented, the most impressive improvements have been in the walk out rate,” says Deb Delaney, RN, senior consultant with BlueJay consulting. “No hospital wants patients who have come for care to walk out because they are frustrated with the wait. In one ED the walk out rate dropped from over 7% before the implementation to 2.7% after the flow facilitator was appointed. Additionally, the overall length of stay for patients improved by over 40 minutes per patient and the customer service scores went from 51% to 83%.”