Improving the Admissions Process

ED Throughput Team - Sharon Hillger RN, ED Clinical Leader, Kris Hering CNO, Dr. Danosi ED Director, Dr. Ephrem Inpatient Hospitalist, Beth Simpson Nurse Director M&S/ OB
ED Throughput Team (from L-R) – Sharon Hillger RN, ED Clinical Leader, Kris Hering CNO, Dr. Danosi ED Director,              Dr. Ephrem Inpatient Hospitalist, Kim Johnstone, RN, MNS Clinical Leader, Beth Simpson Nurse Director M&S/ OB

Patients awaiting admission in the emergency room can cause overcrowding in most emergency departments (EDs) nationwide. It can potentially reduce capacity to treat ED patients, decrease bed utilization, and compromise quality, safety, and the patient experience. Efficient disposition is essential for many reasons. Our community members desire timely care. When ED beds are occupied by patients holding for admission, front-end flow is impacted. Patients may leave without treatment, because of the time they are waiting. In fact, many patient complaints across the industry are often rooted in excessive wait times to see a provider.

Because of this, SMH has put together an ED Throughput Committee, which is comprised of physicians, clinical leaders and nurse directors from both the Emergency Room and Inpatient services. The goal of this committee to improve the admission process for our patients who come through the ED and are admitted to our Inpatient units. The ED Throughput process begins with the decision to admit and the process ends when the patient arrives at the inpatient unit.  By working together, we expect to Improve Patient Satisfaction, Standardize the Process, Improve Handoffs, Improve Quality of Care, Increase Staff Satisfaction and Free up ED beds for other patients.

We have been actively collecting data over many months looking at workflow process and standardized practice. Working together, we have identified areas that we need to focus on in order to decrease the amount of time it takes from the decision to admit and the time it takes for the patient to arrive at the inpatient unit.  By collaborating closely with inpatient units, the emergency department at SMH has made time-saving adjustments over the past six and will continue to work toward decreasing wait times for patients in the ED.


Baker, S. J., & Esbenshade, A. (2015). Partnering Effectively With Inpatient Leaders for Improved Emergency Department Throughput. Advanced Emergency Nursing Journal, 37(1), 65–71.

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