Patient Transfer from ER to Inpatient

ContextIn most scenarios, emergency rooms have limited capacity to occupy all the patients

that check into the department. There are numerous reasons that have been tied to the

overcrowding as well. One key reason of this is the lack of appropriate mechanisms and

strategies connecting the ER department and other departments of the hospital. Another

factor is having the incapability to transfer patients from the ER to inpatient beds after a

Patient Transfer from ER to Inpatient

resolution had been made to admit the patient rather than to manage them in outpatient

(Baker, Peter, Morlock, Geocadin, & Holzmueller, 2009).

The fact that the process of transferring a patient from the ER to other departments

does take a substantial amount of time and at times longer than anticipated by most of the

patients seeking the services. Therefore, there are various ways to improve the transfer of a

patient from the ER to inpatient status. With the new business plan, it will use different

strategies and goals to achieve the scope of better and swift transfers between the ER and

other departments.

Scope of the business plan

The main scope of the business plan was to ensure a smooth flow of patients in the

ER and the transfer to inpatient beds at the hospital and other health care facilities. This plan

would in turn reduce the overcrowding problem within the ER, and also avoid delays and

promote patient safety and better quality of care. The improved ER patient flow can be

achieved by reducing the time a patient takes in the ER by utilizing best practices. Also, the

turnaround time of any tests that have to be ordered and then given, which can include any x-

rays, MRI’s, imaging, etc. can be improved. On the physician admission orders, they should

expedite completion of admission orders by the inpatient team for the admitted patients.

Goals

The objective of the business plan is to improve the patient flow in an efficient and

patient-centered way. This can be attained by improving the nurse to patient ratio in the

emergency department from the ratio of 1:4 to 1:3. In ER, there are always patients waiting to

be moved from the ER to another area, but due to the shortage of staff or beds, this leads to

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Patient Transfer from ER to Inpatient

overcrowding. With adequate number of personnel, the admitted patient will be easily

transferred without delay. Similarly reducing the nurses’ patient load will motivate the staff

hence allowing them to be more productive. (Baker, Peter, Morlock, Geocadin, &

Holzmueller, 2009)

With increasing of staff, there is need to increase number of casual staff or porters

that will assist nurses in transferring of patients. Casual staff will be the ones responsible for

the stretchers and wheelchairs, which will be used to transport the patients. Having the extra

staff will help alleviate the workload put onto the nurses within the ER and also will increase

the productivity levels of the ER. Furthermore, one other goal is to improve the methods,

measures and tools used that are currently in place when transferring patients. This can be

achieved through the introduction of bedside registration and a new computer system, which

can keep track the duration a patient, has stayed in ER before admission. This will show the

time a patient took with the doctor and the amount of time that was required for the patient to

be transferred out of the ER to another department.

With the new system, ER nurses will be able to fax, email or enter reports so that

other nurses, doctors or providers located in other inpatient departments have access to the

records.These steps will ensure that beds and equipment are ready for the patients prior to

their arrival at the inpatient rooms.

 

Reference

Baker, D. R., Pronovost, P. J., Morlock, L. L., Geocadin, R. G., & Holzmueller, C. G.

(2009). Patient Flow Variability and Unplanned Readmissions to an ICU. Retrieved from

http://www.medscape.com/viewarticle/711395

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