Improving ED throughput times via a standardized hand-off tool to decrease adverse patient outcomes and overall length of stay: a pilot project

Purpose of Project: This quality improvement project implemented a standardized handoff tool to evaluate impacts on throughput times, and patient flow through the emergency department.Methodology: In an urban, central New Jersey-located level-one trauma center, a retrospective and prospective chart review of patients admitted from the emergency department to one inpatient pilot unit (4T) during the two month implementation period was conducted. Throughput times pre and post handoff tool implementation were studied and compared.Results: Of the 30 patients who met criteria for the pilot project, 43% (n=13) of hand-off tools were completed and used for patient transfer. The median turnaround time was 25.69 hours for the month prior to implementation and increased by 6.62 hours for the following month and increased by 20.19 hours for the month following that. When considered the previous year’s turnaround time for the same month, January 2021 time decreased by 6.52 hours, February’s time decreased by 17.87 hours and March’s time increased by 17.87 hours. For two months prior to implementation the AMA numbers were 44 and 38, and decreased to 35 for the first month of implementation then increased again back to 50 patients. LWBT values were lower pre-implementation. LWOB numbers decreased in the first month of implementation and then increased again to 41 patients. Implications for Practice: Cost-saving measures for the healthcare system, safer patient care, improved quality of patient data being shared, improved throughput times, increased inter- and intra-professional collaboration and communication, decreased adverse outcomes reaching the patients.