Full Answer Section

1. Physician Assessment: (Rectangle)
2. Diagnostic Tests (Labs, Imaging): (Rectangle)
3. Results Waiting: (Rectangle)
4. Decision: Admission/Discharge: (Diamond)
   • Admission: Proceed to 10.
   • Discharge: Proceed to 11.
5. ED Admission Hold (Waiting for Bed): (Rectangle)
6. Discharge/Follow-up: (Rectangle)
7. Patient Leaves Without Being Seen (LWBS) (If wait is too long): (Rectangle)

Proposed Redesigned Process:

1. Patient Arrival at ED: (Rectangle)
2. Rapid Triage & Bed Assignment (If Available): (Diamond – Decision: Urgent?)
   • Yes: Proceed to 3.
   • No: Proceed to 4.
3. Immediate Treatment/Stabilization & Bed Placement (If Available): (Rectangle)
4. Express Registration/Insurance Verification (Simultaneous with Triage): (Rectangle)
5. Point-of-Care Diagnostic Testing (Where Applicable): (Rectangle)
6. Physician Assessment (Concurrent with Diagnostics): (Rectangle)
7. Rapid Results Processing & Communication: (Rectangle)
8. Decision: Admission/Discharge: (Diamond)
   • Admission: Proceed to 9.
   • Discharge: Proceed to 10.
9. Dedicated ED Admission Holding Unit (Short-Stay): (Rectangle)
10. Discharge/Follow-up & Bed Turnover Optimization: (Rectangle)

Summary of Proposed Changes and Impact:

1. Rapid Triage and Bed Assignment (If Available):

• Change: Immediately assess urgency and assign beds or holding areas upon arrival if available.
• Impact: Reduces initial wait times, improves patient flow, and prevents overcrowding.

2. Express Registration/Insurance Verification (Simultaneous with Triage):

• Change: Streamline registration, potentially using mobile devices or self-service kiosks, while triage is occurring.
• Impact: Reduces bottlenecks and frees up staff for patient care.

3. Point-of-Care Diagnostic Testing (Where Applicable):

• Change: Implement rapid diagnostic tests (e.g., blood gas, rapid flu tests) at the point of care.
• Impact: Expedites diagnosis, reduces wait times for results, and facilitates faster treatment decisions.

4. Physician Assessment Concurrent with Diagnostics:

• Change: Physicians initiate assessments while diagnostic tests are being performed.
• Impact: Reduces overall assessment time and speeds up treatment initiation.

5. Rapid Results Processing & Communication:

• Change: Implement a system for rapid processing and communication of test results to physicians.
• Impact: Facilitates faster decision-making and reduces delays in patient management.

6. Dedicated ED Admission Holding Unit (Short-Stay):

• Change: Establish a dedicated unit within the ED for patients awaiting inpatient beds, with focused nursing care.
• Impact: Reduces ED admission hold times, frees up ED beds for new patients, and improves patient comfort.

7. Discharge/Follow-up & Bed Turnover Optimization:

• Change: Implement protocols to expedite discharges and optimize bed turnover, including early discharge planning and improved communication with inpatient units.
• Impact: Increases bed availability, reduces ED congestion, and improves patient flow throughout the hospital.

Overall Impact:

Implementing these changes will:

• Reduce patient wait times in the ED.
• Decrease the number of patients leaving without being seen (LWBS).
• Minimize ED admission hold times.
• Improve patient satisfaction.
• Enhance overall ED efficiency.

By focusing on concurrent processes, rapid diagnostics, and streamlined patient flow, Charleston General Hospital can significantly improve its ED operations and provide better care to its community.