title: Impact of a Planned Workflow Change: Super Track Improves Quality and Service for Low-Acuity Patients at an Inner-City Hospital.
abstract: ED volume and acuity were anticipated to increase at an inner-city hospital. A strategy to mitigate the impact was needed.
  
  
  METHODS
  A multidisciplinary team facilitated a workflow modification project implementing a Super Track to treat low-acuity patients. A literature review led to the creation of an evidence-based framework. Staff education regarding the change process and the results of an analysis in the strengths, weaknesses, opportunities, and threat format, along with simulation exercises and a pilot project, supported implementation of this strategy.
  
  
  RESULTS
  Simulation exercises demonstrated that the proposed workflow with a Super Track had the potential to reduce the length of stay among level 4 and 5 patients coming to the emergency department. Implementing a Super Track reduced the patient arrival-to-provider time for low-acuity patients, but length of stay was not affected. After implementation, the number of patients who left without being seen decreased by 40%, and patient satisfaction increased by 36%.
  
  
  CONCLUSIONS
  A modified front-end workflow process produced a statistically significant, sustainable improvement in patient flow of low-acuity patients in our emergency department. Use of an evidence-based, multidisciplinary team approach supported the change process.
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA. Electronic address: nbonalumi@comcast.net.
authors.forename: Nancy Mannion
authors.initials: NM
authors.lastname: Bonalumi
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: Anand
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Edwards
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: Allen
authors.initials: A
authors.lastname: Fasnacht
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: LeighAnn
authors.initials: L
authors.lastname: Mazzone
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Stephens
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: Kim
authors.initials: K
authors.lastname: Whiteman
authors.affiliation: Philadelphia, Waynesburg, and Pittsburgh, PA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Swanson-Bierman
mesh_terms: D017598:Efficiency, Organizational / Q000706:statistics & numerical data; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006786:Hospitals, Urban; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D062072:Patient Acuity; D013997:Time Factors; D057188:Workflow
keywords: Emergency department; Patient throughput; Provider in triage; Super Track