SHM Converge Scientific Abstract ePoster Gallery-Innovative Admission Workflow: A Path to Greater Efficiency and Team Satisfaction

Pdf Summary

Jefferson Health–Lehigh Valley identified admission workflow delays across 15 hospitals, mainly caused by inconsistent decisions about level of care and which service should admit the patient. These delays slowed the transition from the emergency department to inpatient care, increased wait times, and added strain for both Hospital Medicine (HM) and Emergency Medicine (EM) teams.<br /><br />To address this, the teams redesigned the admission process with the goals of improving patient safety, increasing throughput, reducing delays in order placement, and improving clinician satisfaction. The new workflow was developed through multidisciplinary collaboration, including input from subspecialists, and focused on standardizing admission criteria and communication.<br /><br />Key changes included:<br />- surveying EM and HM teams to identify diagnoses and services commonly associated with delays,<br />- establishing clear criteria for ICU-level care and specialty service admissions,<br />- using secure messaging with SBAR formatting to initiate admission requests,<br />- requiring EM clinicians to confirm key clinical and logistical factors before sending the request,<br />- setting clear response times for HM triage and admitting clinicians.<br /><br />Under the new process, HM triage is expected to review referrals within 30 minutes and either place bed requests or instruct EM to place streamlined admission orders within 15 minutes. If HM does not act within that window, EM clinicians may place the orders. Patients needing in-person assessment first, such as those with high MEWS or deterioration scores, altered mental status, respiratory problems, intoxication, or step-down needs, are excluded from the streamlined pathway.<br /><br />Overall, the intervention reduced delays between the admission decision and order placement, improved workflow efficiency, and enhanced satisfaction among care teams.

Asset Subtitle

Shadi Jarjous

Meta Tag

Author List Kevin Weaver, Shadi Jarjous

Category Innovations

Concept Admission Workflow Redesign

Concept Patient Safety

Concept Throughput Efficiency

Concept Admission Criteria

Concept Level of Care

Distinguished Non-Finalist

Presenter Organization Jefferson Health-Lehigh Valley Region

Presenting Author Shadi Jarjous

Track Quality Improvement

Keywords

admission workflow

hospital medicine

emergency medicine

patient throughput

workflow delays

SBAR messaging

admission criteria

order placement

care transitions

multidisciplinary collaboration

Admission Workflow Redesign

Patient Safety

Throughput Efficiency

Admission Criteria

Level of Care