Improving Patient Flow From the Emergency Department Utilizing a Standardized Electronic Nursing Handoff Process.

OBJECTIVE: The goal of this project was to decrease handoff delays from the emergency department (ED) as measured by ready to move (RTM)-to-occupied time.

BACKGROUND: ED boarding compromises the quality, safety, and experience of patient care. Lack of standardized and transparent handoff communication contributes to boarding time. This process improvement initiative implemented a standardized electronic situation, background, assessment, and recommendation (eSBAR) format-based nursing handoff process from the ED to a medical unit.

METHODS: Nursing staff were educated face-to-face regarding the initiative background, significance, and process. Outcomes were measured before and after eSBAR implementation.

RESULTS: Before implementation, the house-wide average RTM-to-occupied time was 83.6 minutes. This decreased to 49 minutes (a 41.4% decrease) 3 weeks after implementation and improved further to 47 minutes at 10 months after implementation. No related patient safety or quality issues were identified.

CONCLUSIONS: The use of an electronic, standardized handoff communication process resulted in decreased boarding time and increased bed flow efficiency.