title: Use education to get staff on board with a team-approach to care.
abstract: Immediate bedding and the practice of swarming--delivering patient care as a team--can significantly slash wait times and overall length-of-stay in the ED. However, getting physicians and nurses to transition to such approaches is challenging because they must work at a higher pace than they are used to. Veterans of these approaches from Henrico Doctor's Hospital in Richmond, VA advise ED administrators to think through how these approaches would work in their own settings and obtain staff buy-in prior to implementation. Swarming typically requires repeated practice before it gels. Assigning personalities that work well together to the same team on a consistent basis may enhance effectiveness. Explain to staff that the transition to a swarming approach will be hard, but it will deliver dividends over the long term. Make contingency plans for days when the ED is short-staffed or volume is unusually high. Swarming does not work well in departments that are under-staffed. Consider the creation of an "expeditor" position. This is a veteran nurse who has the skills and experience to float wherever she is needed in the ED.
mesh_terms: D003299:Cooperative Behavior; D004636:Emergency Service, Hospital; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education*; D009042:Motivation; D005791:Patient Care; D014481:United States