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Nursing Informatics- How to investigate LWBS patients.. HELP!!

Informatics   (2,729 Views 6 Comments)
by SAQU0915 SAQU0915 (New Member) New Member

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I've been doing some reading over the weekend for my nursing informatics class, and I am having a difficult time understanding the concept of investigating patients who have left the emergency room without being seen. One of the chapter readings have a scenario which I cannot understand for the life of me... so I am wondering if anyone can help me understand these questions or lead me into the a direction where I can get some more information :smokin:

A patient satisfaction survey has reported that patients are leaving the emergency department (ED) at your hospital without being seen and have complained about the ED to the media. The CEO has asked you to investigate.

*How would you determine the cause of the problem?

*How would you determine the extent of the problem?

*How would you evaluate the impact of the problem on patient safety? On the organization?

*Whom would you work with to improve the situation?

*How would you conclude that improvements have been made?

*What data would you use?

*Where would you get these data?

*How would you evaluate the cost of improvements in relation to the benefit?

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tnbutterfly is a BSN, RN and works as a Content/Community Director @ allnurses.

13 Followers; 116 Articles; 193,739 Visitors; 5,325 Posts

Moved to Nursing Informatics forum.

I hope someone will come along and address your questions.

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rninformatics has 30 years experience as a BSN, RN and works as a Director, Clinical Informatics.

30,042 Visitors; 1,267 Posts

Thank you tnbutterfly. Your wish is my command!:)

Moved to Nursing Informatics forum.

I hope someone will come along and address your questions.

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3 Followers; 95,648 Visitors; 36,460 Posts

Unless someone took the time and effort to fill out a satisfaction form on their way out the door, how would you have access to those who left without being seen? I have left without being seen and I can say that the last thing I wanted to do was fill out a form on my way out of there.

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rninformatics has 30 years experience as a BSN, RN and works as a Director, Clinical Informatics.

30,042 Visitors; 1,267 Posts

Perhaps your instructor wants you to look at what "data" the organization's HIS ( Health Information Systems) collect to answer these questions.

Okay, lets start with looking at the "cause of the problem" and or the "extent of the problem" maybe look at reports in the system that tell you what time the patient arrived and was triaged. Was the time between the two - the wait time - unreasonably long for the patient's condition? Is that why the patient left?

Does the ED application have reports or collect data on pts who have LAMA (left against medical advice) or LWBS (left without being seen)? Can you see any trends? Like the numbers are higher on night shift or during the weekend , or when staffing may be thinner???

Did registration or the triage nurse document any subjective comments from the patient or objective observations that may give a clue to the pt's state of mind, response to care, unusual circumstances etc??

What about looking at the organizations Quality indicators, past patient satisfaction survey's for data?? Does the organization have a specific HIS application that collects PI/QA stats and data per dept?

Clarify with your instructor is the last question asking you to do a Cost Benefit Analysis related to current state and system improvements???

Not wanting to do your assignment for you.............hope that helps

I've been doing some reading over the weekend for my nursing informatics class, and I am having a difficult time understanding the concept of investigating patients who have left the emergency room without being seen. One of the chapter readings have a scenario which I cannot understand for the life of me... so I am wondering if anyone can help me understand these questions or lead me into the a direction where I can get some more information :smokin:

A patient satisfaction survey has reported that patients are leaving the emergency department (ED) at your hospital without being seen and have complained about the ED to the media. The CEO has asked you to investigate.

•How would you determine the cause of the problem?

•How would you determine the extent of the problem?

•How would you evaluate the impact of the problem on patient safety? On the organization?

•Whom would you work with to improve the situation?

•How would you conclude that improvements have been made?

•What data would you use?

•Where would you get these data?

•How would you evaluate the cost of improvements in relation to the benefit?

Edited by rninformatics
adding more

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rninformatics has 30 years experience as a BSN, RN and works as a Director, Clinical Informatics.

30,042 Visitors; 1,267 Posts

The patient leaving would not have to fill out a form. Many ED assessments (paper or computerized) have a section/screen/query/question that the nurse or registration staff complete related to patients that have LAMA or LWBS.

Unless someone took the time and effort to fill out a satisfaction form on their way out the door, how would you have access to those who left without being seen? I have left without being seen and I can say that the last thing I wanted to do was fill out a form on my way out of there.

Edited by rninformatics
cause

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