SHM Converge Scientific Abstract ePoster Gallery-Enhancing Patient Flow by Implementing Standardized Admission Guidelines: A Collaborative Approach to Service Assignment for Patients With Orthopedic Trauma

Enhancing Patient Flow by Implementing Standardized Admission Guidelines: A Collaborative Approach to Service Assignment for Patients With Orthopedic Trauma

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This article describes an initiative to improve emergency department flow for patients with orthopedic trauma by creating standardized admission guidelines for service assignment. At the authors’ hospital, these patients could be admitted to Trauma Surgery, General Medicine, or Orthopedics, which often led to inconsistent decisions and delays while teams debated placement. Because ED boarding time affects both patient safety and experience, the team sought a clearer, more collaborative process.<br /><br />Representatives from patient placement, the ED, Trauma, Orthopedics, and other leaders worked together to draft criteria based on injury details, patient age, and high-risk comorbidities. Each department reviewed the draft internally, helping build consensus around areas that previously caused disagreement. After approval by the Trauma Quality Multidisciplinary Committee, the guideline was shared with the involved departments and posted on an internal website for easy access.<br /><br />The guideline was then used for all applicable patients. The authors compared outcomes for six months before and six months after implementation among ED-evaluated patients with orthopedic trauma who required non-ICU admission. After the guideline was introduced, admissions to Medicine decreased from 79.4% to 64.3%, while combined admissions to Orthopedics and Trauma increased from 20.6% to 35.7%. Median time from admission request to service assignment improved from 92 minutes to 73 minutes, and median ED boarding time decreased from 249 minutes to 186 minutes.<br /><br />Overall, the project shows that standardized, collaboratively developed admission criteria can improve transparency, reduce delays in service assignment, and shorten ED boarding time for orthopedic trauma patients.

Asset Subtitle

Benjamin P. Buettner

Meta Tag

Author List Benjamin P. Buettner, Bethany Kranitzky

Category Innovations

Concept Admission Guidelines

Concept Patient Flow

Concept Emergency Department Boarding Time

Concept Service Assignment

Concept Orthopedic Trauma

Distinguished Non-Finalist

Presenter Organization The Ohio State University Wexner Medical Center

Presenting Author Benjamin P. Buettner

Track Quality Improvement

Keywords

orthopedic trauma

emergency department flow

admission guidelines

service assignment

ED boarding time

trauma surgery

general medicine

orthopedics

patient placement

standardized criteria

Admission Guidelines

Patient Flow

Emergency Department Boarding Time

Service Assignment

Orthopedic Trauma