School of Nursing
Doctor of Nursing Practice (DNP)
Emergency Department Overcrowding, Team Triage, Provider in Triage, ED Quality Indicators, Patient Flow, Throughput Metrics
Sizemore, Kirsten Gisela, "Reducing Emergency Department Length-of-Stay and Overcrowding through Team Triage" (2019). Doctoral Dissertations and Projects. 2258.
Emergency department (ED) overcrowding is an internationally studied phenomenon linked to adverse patient outcomes, including death. Early medical screening exams (MSE) may prevent morbidity and mortality. Yet, EDs struggle to evaluate, treat, and discharge patients within recommended and nationally monitored benchmark times. This evidence-based scholarly project explored if stationing an advanced practice provider (APP) in triage would improve door-provider-times, length-of-stay (LOS), and the left without being seen (LWBS) rate at a medical center ED in the southeastern United States. A pre- and post-intervention design compared benchmark times after a provider triaged alongside the registered nurse (RN) during times of high census. The provider performed MSE and ordered diagnostic tests. Comparison of the two triage methods showed a significant reduction of median door-to-provider time, a decrease in LOS, and decline in LWBS rates. These findings indicate that stationing a provider in triage during times of high patient census can improve benchmark times and overcrowding.