Streamlining the Intake Process of Cardiac Patients in the Emergency Department

The goal was to improve turnaround times of troponin and EKGs within the cardiac patient population in the emergency department. The chief nursing officer led this initiative, utilizing Lean methodology with an interdisciplinary approach, focusing on streamlining patient flow. Strategies for improvement included revising the care delivery model during high volume times and shifting to a nurse initiated triage protocol, including STAT EKGs and STAT labs.

The outcome was a 62 percent improvement in door-totroponin results within 60 minutes, and a 32 percent improvement in door to EKG within 10 minutes. As a result, length of stay for cardiac patients decreased by 11 minutes and patients who left without being treated decreased to 1.59 percent.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)