title: ED flow facilitators make throughput center stage, achieve decreases in LWBS, LOS, and door-to-bed times.
abstract: With volume and the left-without-being-seen (LWBS) rate on the increase, Mercy Hospital in Springfield, MO, created a new ED flow facilitator position to take charge of throughput.The ED flow facilitator is a nurse who assigns patients to the east and west zones of the department, and also handles all ambulance calls. The approach has helped the ED bring the LWBS rate from 8% to the 3% to 5% range, and it has also made a dent in length-of-stay and door-to-bed times, but rising volume continues to be a challenge. When the flow facilitators were first implemented in late 2010, yearly volume in the ED was 93,000. This year the ED is on track to see 97,000 to 100,000 patients, which is still very high compared to other EDs. Good flow facilitators are nurses with supervisor potential who typically prefer to stay involved with nursing care. They need to be able to multi-task and handle high levels of stress. Hospital administrators note that patient flow patterns need to be under constant review in order to fashion solutions that make sense for the ED.
mesh_terms: D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay; D019982:Organizational Case Studies; D010342:Patient Acceptance of Health Care; D010360:Patient Transfer / Q000458:organization & administration*; D014481:United States