title: Rapid intake, empowered nursing staff energize no-wait ED model.
abstract: By empowering front-line staff to come up with some of their own solutions, the ED at Swedish Medical Center in Issaquah, WA, has implemented a no-wait model that eschews traditional triage in favor of a rapid intake process that puts patients in beds immediately and kick-starts the evaluation process. While the approach has proven challenging to implement and maintain, patient satisfaction is greater than 95%. The no-wait model was developed and fine-tuned by the staff at a free-standing ED that preceded the opening of the hospital in Issaquah, WA. Key to the approach is a team-based system that puts all personnel on the same level with no hierarchical structure. In the model, charge nurses are under constant pressure to make sure a room is always available for the next patient, and nursing staff are empowered through protocols and standard order sets to respond to patient needs before physicians complete their assessments.
mesh_terms: D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital; D006801:Humans; D017146:Models, Organizational; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D014850:Waiting Lists