Date of Award

Summer 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

Departments (Collect)

Department of Nursing

Program or Major

Direct Entry Master's of Nursing

Degree Name

Master of Science

First Advisor

Deborah Simonton

Second Advisor

Pamela Kallmerten

Abstract

Abstract

Background: A Critical Access Hospital in New England faces communication challenges in its Emergency Department, impacting patient flow and safety. The current paper charting system leads to delays and inefficiencies.

Local Problem: The communication gap between ordering laboratory tests and providers reviewing results at the patient’s bedside averages 130 minutes, contributing to delays and potential patient safety issues.

Methods: Using the Plan-Do-Study-Act model, a visual communication system was implemented. Laminated labels indicating pending lab, CT, and radiology reports were affixed to patient folders. Data was collected pre- and post-intervention to measure time from lab order to provider review.

Interventions: Laminated labels with test details and order times were attached to patient folders. Staff tracked the completion of tests using tally marks on the labels. The intervention aimed to reduce the time from ordering tests to provider review by 20%.

Results: The intervention led to an average reduction of 11 minutes in the time from ordering tests to provider review, though the reduction was not statistically significant (p=0.39). The visual system increased staff collaboration and awareness but faced challenges during peak periods.

Conclusion: While the visual communication system did not achieve statistically significant results, it showed potential for improving workflow efficiency and communication. The intervention highlights the importance of effective communication tools in the ED and suggests potential adaptions for other setting using paper charting systems.

Keywords: Communication, Emergency Department, Paper Charting, Visual Communication System, Patient Safety, paper chart*, paper document*, handwritten document*, hand written document*, trad* document*, emergency room, emergency department, emergency medicine, and emergency ward.

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