In 2010, to expedite throughput
in their increasingly busy ED, the
University of California San Diego
Medical Center (UCSD) implemented
standardized symptom-based protocols.
This enabled UCSD to
leverage the skills of their primary
nurses and begin treatment of
patients with specific symptomology
at the first point of assessment. With
standardized pathways, patients
with abdominal pain, respiratory
complaints, or psychiatric needs are
receiving more timely and efficient
treatment. Among the benefits are
shorter wait times and a significant
increase in patient satisfaction scores.
As volume continues to grow, EDs
that employ standardized treatment
protocols upon patient arrival can
further optimize nurses’ assessment
skills, and more effectively care for
patients across diverse needs. Acute
patients are efficiently triaged and
cared for in the appropriate setting,
while those with less pressing needs
can often be discharged from the
waiting room. Organizations that
have cultivated trust and teamwork
behaviors among providers will be
most successful in employing these
interventions.