Bed Assigned to Beds Occupied: A Quality Improvement Project
Authors
White, Jewel
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- Embargoed until 2026-05-22
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Abstract
Background: Delays in patient throughput threaten patient safety and satisfaction, particularly in the Emergency Department (ED), where prolonged wait times occur after admitting orders are placed. Between September and December 2023, patients at a suburban hospital waited an average of 99 minutes to occupy their assigned bed, exceeding the national benchmark of 60 minutes set by Leapfrog. The prolonged wait time contributes to ED boarding. According to the literature, admitted patients not occupying their inpatient hospital beds can lead to decreased patient satisfaction, delays in medication administration, and an increased risk for cardiovascular events. Purpose: This quality improvement initiative aims to reduce wait times for patients admitted to an Observation Unit (OBS) from the ED through real-time wireless communication notifications among ED nurses, thereby streamlining patient flow and improving throughput. Methods: Over a 15-week implementation period, data on the time to bed assignment to bed occupancy and bed assignment to ED departure were collected through chart audits. Facilitation of timely patient transport occurred after nurse-to-nurse wireless communication of the assigned bed, rather than documentation of electronic Situation, Background, Assessment, and Recommendation (eSBAR) in the electronic health record (EHR). Results: The data indicated that the average times from Bed Assigned to Bed Occupied and Beds Assigned to ED Departure did not meet the less than 60-minute benchmark. Conclusions: Overall, wait time maintains an average above the goal benchmark, with average times improving but not consistently achieved. Key barriers included patient care demands, staffing shortages, and challenges in charge nurses' compliance with additional tasks. Long-term sustainability may be achieved by improved communication and chart alerts.
