This is the worse idea I have every heard of-not safe.

Mia_2011 · Mar 1, 2012

That's the way it is at my hospital. Personally, I'm not a fan. We have received patient's who were not stable for our floor and there have a few times where they brought up the wrong patient, didn't bring admission orders, etc.

It's a bit of a mess. They need to be really organized or sometimes they are over the 30 minutes.

BrnEyedGirl, BSN, MSN, RN, APRN · Mar 1, 2012

I have worked at places that do this. I'm not sure why you think that bedside report will cause the patients to be unstable? The hospital I work for now has discussed this as an effort to move patients faster. There are times when we have 10 patients waiting to go upstairs while there are 30 in the waiting room! I understand the need to move patients, and that the longer a patient waits in the ER, the longer a patient waits in the waiting room. We do electronic physician ordering so forgetting the orders isn't an issue. We also have a transport team that can take our patients up if they are stable and aren't going to an ICU. Giving bedside report would mean a nurse must leave the department, and her/his other patients to transport the patient and give report. Doesn't sound like a huge time saver to me! I like the concept of bedside reporting, but it isn't as easy as it sounds to be, for instance the ER documents on one software, the rest of the hospital on another, and of course they don't talk to one another. If I were to give bedside report from the ER, I would have to print out our chart and take it with me, which is doable but again not a real time saver.

Altra, BSN, RN · Mar 1, 2012

Why the assumption that the admitting MD (not the ER ) would send the patient to an inappropriate unit using this report system in place of whatever you are doing now?

MN-Nurse, ASN, RN · Mar 1, 2012

Feb 28 by jlog.j
Feb 28 by jlog.j A member since Feb '12. Posts: 4 Likes: 1
The hospital I work for is wanting to get ER admits to the floor within 30 minutes of a room assignment being given.

LOL. I can't get a room cleaned in under an hour.

jlog.j · Mar 1, 2012

We are a small hospital, we only have 1 unit-M/S to admit to and administration wants as many admissions as possible and as quickly as possible. Apparently we (m/s nurses)are not discharging and admitting fast enough. Again, I am very concerned for pt safety.

brownbook · Mar 1, 2012

It is wonderful that your main concern is patient safety. However I can't see how having patients wait in a busy ER is any safer than getting them admitted to their M/S unit as quickly (and safely) as possible. It is not like they are getting one to one care in the ER?!

Again you concern is appropriate. Unfortunately there is no one easy solution. It takes commitment from ER and M/S to work together. Just saying "30 minutes" doesn't solve any problem and puts pressure on both units.

You could get a committee together, meet with ER staff and administration. You have to identify the problem (why admits sometimes take a long time to get to the floor.) Hopefully people will come to meetings with a lets solve this, not lets blame each other attitude.

Or give it a try and after a few days or weeks have a short concise list of how it is working, why it doesn't work, and when it does work what were the condidions that day.. Identify problem areas, give this list to administration along with some solutions you have come up with?

Altra, BSN, RN · Mar 1, 2012

If you are a small hospital with only one level of care ... that isn't changing. All that's changing, from what I read that you've posted here, is that your hospital is trying to cut down on the time that an inpatient bed is unoccupied. In other words, from the time the bed is assigned, 30 minutes is enough time to get the patient handed over and physically transported from point A to point B. You make no mention of expanded specialty services, or an increased number of beds without increased staff, or anything else that I can see that ups the acuity.

The alternative is for patients to remain longer in a potentially chaotic ER.

psu_213, BSN, RN · Mar 1, 2012

It does sound like a not so good idea. I have been in the position of receiving a pt from the ER without any report. They would show up, I would say "I didn't know that you were bringing this pt up." The reply "Oh, well I faxed report" (and then walk away as if I did not have a right to know anything about the pt). When we went to a EMR it helped--I could look at all the ER notes/VS/txs, etc before the pt came to the floor. If you don't have that is their any way they can fax the hand written notes/MAR, etc to the floor before they bring the pt?

LynnLRN · Mar 1, 2012

I feel like this is coming from the "obama healthcare reform" with all the hcaps and financial rewards to hospitals based on certain dashboards and patient satisfaction. They are monitoring ER waiting times and the time it takes from being seen in the ER, being changed to an inpt and after that how long it takes the ER to get the pt the floor.

Altra, BSN, RN · Mar 1, 2012

I feel like this is coming from the "obama healthcare reform" with all the hcaps and financial rewards to hospitals based on certain dashboards and patient satisfaction. They are monitoring ER waiting times and the time it takes from being seen in the ER, being changed to an inpt and after that how long it takes the ER to get the pt the floor.

HCAHPS predates the Patient Protection & Affordable Care Act by several years, and it does not include any questions regarding transfer between units.

The actual survey is here:

http://www.hcahpsonline.org/Files/HCAHPS%20V6%200%20Appendix%20A%20-%20HCAHPS%20Mail%20Survey%20Materials%20(English)%202-16-2011.pdf

jlog.j · Mar 4, 2012

Great advise. Thank you very much. I'll let everyone know how it works out.