Reducing Patient Wait Times in the Rural Emergency Department

Abstract

Purpose: This quality improvement project aims to assess the effectiveness of standing orders to improve patient wait times in a rural emergency department. Background: Extended emergency department wait times are an ongoing issue, regardless of the size of the hospital or service area population. Long wait times could lead to poorer patient outcomes and can result in patients leaving without seeking the necessary follow-up. Therefore, evaluation of potentially beneficial interventions to reduce wait times is essential to improve this problem. Methods: The Centers for Disease Control Framework for Evaluation and the Plan-Do-Study-Act implementation models were used to evaluate the efficacy of a standing order policy in a rural hospital. If the standing order policy does reduce patients wait times according to the evaluation of pre- and post-policy implementation data in conjunction with staff feedback, additional standing orders will be implemented to further improve efficiency and throughput. Results: Overall, patient wait times improved and staff feedback was mostly positive. Although there is still room to improve the number of patients who left without being seen, the project improved communication between medical and nursing as tensions increased during a global pandemic. Conclusions: Within the given research, there are several barriers to improving patient wait times in the emergency department. Causes for extended wait times include available space for assessment and care, the number of staff, efficiency of flow and allied services, and limited resources. While not all these barriers are easily corrected in a rural hospital, minor evidence-based adjustments can positively impact patient outcomes and overall satisfaction.