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Improving hospital flow ‘Ensiab Project’

Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction. This artic...

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Autores principales: Alotaibi, Yasser, Alnowaiser, Noura, Alamry, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479940/
https://www.ncbi.nlm.nih.gov/pubmed/34583936
http://dx.doi.org/10.1136/bmjoq-2021-001505
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author Alotaibi, Yasser
Alnowaiser, Noura
Alamry, Ahmed
author_facet Alotaibi, Yasser
Alnowaiser, Noura
Alamry, Ahmed
author_sort Alotaibi, Yasser
collection PubMed
description Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction. This article describes the efforts of six tertiary care governmental hospitals in the Kingdom of Saudi Arabia that have enrolled in a collaborative improvement project to reduce ED boarding time. The hospitals implemented a multifaceted system intervention that included forming multidisciplinary flow improvement teams, implementing the National Health Service (NHS) SAFER patient flow bundle, visual management system and multidisciplinary ED bed huddles. By the end of the project, all hospitals significantly reduced ED boarding time with a pooled mean difference of – 7.1 hours (16.6 before, 9.5 hours after, p<0.001), reaching a pooled average of 2 hours in March 2020. Furthermore, by the end of the third learning session, all hospitals were able to achieve a boarding time below 6 hours. The enrolled hospitals also experienced an improvement in hospital flow process measures without any increase in 30-day readmission rates or bed occupancy rates. Our project demonstrates that implementing multifaceted system-wide interventions improves hospital flow and ED boarding time. Additionally, our project demonstrates a significant correlation between improvements in ED boarding time, daily consultant-led rounds and early discharge from inpatient units and time till discharge.
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spelling pubmed-84799402021-10-14 Improving hospital flow ‘Ensiab Project’ Alotaibi, Yasser Alnowaiser, Noura Alamry, Ahmed BMJ Open Qual Quality Improvement Report Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction. This article describes the efforts of six tertiary care governmental hospitals in the Kingdom of Saudi Arabia that have enrolled in a collaborative improvement project to reduce ED boarding time. The hospitals implemented a multifaceted system intervention that included forming multidisciplinary flow improvement teams, implementing the National Health Service (NHS) SAFER patient flow bundle, visual management system and multidisciplinary ED bed huddles. By the end of the project, all hospitals significantly reduced ED boarding time with a pooled mean difference of – 7.1 hours (16.6 before, 9.5 hours after, p<0.001), reaching a pooled average of 2 hours in March 2020. Furthermore, by the end of the third learning session, all hospitals were able to achieve a boarding time below 6 hours. The enrolled hospitals also experienced an improvement in hospital flow process measures without any increase in 30-day readmission rates or bed occupancy rates. Our project demonstrates that implementing multifaceted system-wide interventions improves hospital flow and ED boarding time. Additionally, our project demonstrates a significant correlation between improvements in ED boarding time, daily consultant-led rounds and early discharge from inpatient units and time till discharge. BMJ Publishing Group 2021-09-28 /pmc/articles/PMC8479940/ /pubmed/34583936 http://dx.doi.org/10.1136/bmjoq-2021-001505 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Quality Improvement Report
Alotaibi, Yasser
Alnowaiser, Noura
Alamry, Ahmed
Improving hospital flow ‘Ensiab Project’
title Improving hospital flow ‘Ensiab Project’
title_full Improving hospital flow ‘Ensiab Project’
title_fullStr Improving hospital flow ‘Ensiab Project’
title_full_unstemmed Improving hospital flow ‘Ensiab Project’
title_short Improving hospital flow ‘Ensiab Project’
title_sort improving hospital flow ‘ensiab project’
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479940/
https://www.ncbi.nlm.nih.gov/pubmed/34583936
http://dx.doi.org/10.1136/bmjoq-2021-001505
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