Do You Need a Patient Flow Coordinator in Your Emergency Department?

Two Nurses Meeting

It’s Emergency Nurses Week. Do you have someone filling the critical role in your ED? The role of the patient flow coordinator — or nurse — is to ensure patients receive the highest quality of healthcare in the timeliest manner. They do this two ways:

  • By streamlining the flow of patients through the emergency department from admission to discharge or transfer;
  • And by helping hospital staff, in and outside the ED, provide a level of care that exceeds expectations.

So, if patient flow coordinators are so vital to the quality of care and patient satisfaction, why aren’t they more common in the ED? Is it not worth the investment?

How Patient Flow Coordinators Can Improve Numbers

A 2012 research study published in the Journal of Emergency Nursing contends that the initial investments necessary to create these positions do pay off over time.

Researchers conducted their study at an urban academic medical center facing issues related to overcrowding within its ED. A “fast track” area was implemented, the size of the ED was increased, beds were placed in the hallway and ambulances were diverted. But only by assigning an emergency nurse as a flow coordinator to “affect patient throughput in the emergency department,” were researchers able to see a considerable decrease in patient length of stay, LWBS rate and monthly hospital diversion.

By the numbers:

  • Length of stay decreased by 87.6 minutes.
  • LWBS rate decreased by 1.5 percent.
  • Monthly hospital diversion decreased from 93 hours to 43.3 hours.

Patient Flow Coordinators Can Positively Impact Your Bottom Line

The researchers also remind us these decreases have a significant impact on a hospital finances:

  • Decreasing monthly hospital diversion by an average of 49.8 hours per month leads to a decrease of almost $20 million in lost potential charges annually.
  • By lowering the LWBS rate by 1.5 percent, nearly $5 million in lost potential charges are saved annually.

And of course, if length of stay can be decreased by nearly 90 minutes, patient satisfaction will surely increase.

Another example highlighting the benefits of patient flow nurses and coordinators is one out of Lexington, Kentucky.

Discharge Can Become a Priority

This article tells the story of Baptist Health Lexington COO and CNO Karen Hill, who created a patient flow nurse position when she realized her RNs weren’t consistently making patient discharge a top priority. Instead, they were focusing on those patients that were most unstable or had the highest acuity levels.

Hill tells Health Leaders Media, "I've seen a huge transition in my nursing career from high-acuity hospital focused care to, now, a focus on wellness across the care settings. As we've done that, one of the things that I've tried to do is to help develop a different way to look at hospital care."

By creating the discharge/flow nurse position at Baptist Health Lexington, Hill was not only able to improve quality metrics and transition care while lowering staff turnover, but patients were being discharged more efficiently, a decrease in readmission occurred along with an increase in patients’ levels of education regarding discharge.

The data makes it clear that patient flow nurses and coordinators are a valuable supplement to any ED. But creating these positions and integrating them within an already established ED dynamic and culture isn’t easy. Donovan and Partners can help you assess your ED and determine the best course of action when it comes to staffing your ED with patient flow coordinators. Contact us today.



Health Leaders Media: “How Patient Flow Nurses Help Cut Readmissions”

Journal of Emergency Nursing: “Does an ED Flow Coordinator Improve Patient Throughput?”

New Patient Flow Strategies? What to Keep in Mind for Implementation

Nursing Team

Improving the patient flow process in your emergency department relies heavily on not only what strategies and solutions you choose to implement but also how you decide to implement them.

A strong correlation exists between efficacy and execution. A detailed patient flow implementation plan acknowledges potential challenges and barriers, includes a detailed timeline and offers flexibility. By having one in place, you’ll increase your odds of success.

While your new patient flow process — and the strategies and solutions you’ve decided upon to create it — may seem foolproof on paper, below are  a few things you should consider before, during and following implementation.

Start slow. 

Improving patient flow isn’t a sprint; it’s a marathon. Expect to tweak your plan and strategy during the implementation process and adjust accordingly. Also, give a strategy or solution time to take effect. Like the medication prescribed to patients, relief isn’t always immediate. It takes time, and significant impact may arrive only after another component of the plan has been enacted.  

Create a communication plan. 

Ensuring your plan’s success will be a team effort. From hospital administrators to ED support staff, getting their buy-in will be critical and will require effective communication between stakeholders. Before launch, develop a communication plan with your patient flow team that will enable you and your team to troubleshoot any issues or concerns as they arise and to make sure everyone is on the same page.

Whether you schedule a daily in-person huddle, weekly Skype session, conference call, email thread or group chat, make sure the lines of communication are open and that all of your team members have an opportunity to share their voice as you implement your plan.   

Be realistic. 

This may be the most important thought to consider when implementing new patient flow strategies. To effect change in the ED, you have to take into account what your resources are and how they will determine your results.

For example:

  • Figure out early on whether or not you have the budget to implement new strategies. You must also determine if the results of implementation will provide a positive return on investment for both your bottom line and the quality of care your ED delivers to patients.
  • Consider personnel resources. If your patient flow plan consists of developing or adding a new position — think patient flow navigator — do you have the money to make it happen? If not, will you be able to secure more funds? How long will it take? Also, determine whether or not your plan will require staff to learn new skills.     

Take time to reflect. 

When you carefully consider each component or strategy you plan to implement it will prepare you for any hiccups along the way. It can give you time to create buy-in among your teammates and opens the lines of communication between one another. Devoting ample time for pre-launch review and dialogue among staff will make improving patient flow that much easier.

What else should one consider when working to improve patient flow within the emergency department? Share your comments below or feel free to drop me a line with your experience.


SOURCE: Agency for Healthcare Research and Quality: “Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals.”