Destination Arrival and Discharge Unit to Improve Patient Flow

The increase in patients presenting to the emergency department (ED) for primary care poses a serious safety issue in the care that can be provided. In a care area that is overcrowded, physicians, nurses, ancillary department staff, and other care team members may have a difficult time delivering care. Poorly managed flow in the ED leads to overcrowding, and patients with life-threatening illnesses are less likely to be transitioned to designated specialized areas in a safe and efficient manner. The practice-focused question was whether processes to improve the flow of patients entering the ED decreased the number of patients leaving without being seen, decreased time from the time entering the ED to hospital admission, improved the average length of stay, and increased patient satisfaction. The plan-do-check-act methodology was used to address this quality improvement project. Results of the project demonstrated a decrease in the number of patients leaving without being seen, a decrease in the time entering the ED to hospital admission, a decrease in average length of stay, and an increase in patient satisfaction. This project provided positive social change to the patients, families, organization, and community by improving the ED processes to ensure patient needs were addressed as rapidly as possible