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Time from ED to Inpatient Bed (median)
10/22/2003 9:02:17 PM
User Comments on Time from ED to Inpatient Bed (median)
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Total Posts: 1
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Re: Time from ED to Inpatient Bed (median)
3/22/2007 9:09:45 AM
What is the expected benchmark for the ED to Admit time?
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Kathryn Bennett
Total Posts: 2
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Re: Time from ED to Inpatient Bed (median)
11/28/2007 2:43:01 PM
In defining the decision to admit, what do you use as the deciding time--the admitting MD's direction to admit after communicating with the ED? Our ED physicians are entering the bed request sometimes before they even contact the potential admitting MD. At the very least, they are entering the bed request at the same time they start to contact the potential admitting MD. While they are very good at predicting who will need an inpatient bed, it sometimes causes a delay in the time because the admitting doesn't call them back or make a decision until other tests are run, etc. We are shooting for a 60 minute benchmark, but we want to make sure our start time is the same as other organizations trying to achieve the same benchmark.
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Total Posts: 1
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Re: Time from ED to Inpatient Bed (median)
6/25/2008 2:43:19 PM
Shands HealthCare is also trying to determine a valid benchmark "from ED admission to inpatient bed (median)". If you find one, would appreciate if you could share with us.
Thank you,
Bette Brotherton
Vice President, Clinical Improvement
Shands HealthCare
352-265-0680 x80067
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Marie Johnston
Total Posts: 1
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Re: Time from ED to Inpatient Bed (median)
8/7/2008 8:18:25 AM
We are using a 60 minute benchmark from the time the unit is assignned until pt arrives on the inpatient unit. We are also interested in benchmarks set by national medical centers. Is there a standard out there someone would be willing to share?? Also, what are your thoughts regarding mandating written or phone orders by the ADMITTING MD (not the ED MD)BEFORE the pt arrives on the inpatient unit? Thank you, Marie Johnston
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Total Posts: 12
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Re: Time from ED to Inpatient Bed (median)
8/15/2008 9:22:55 AM
Posting on behalf of Jody Crane, MD faculty for IMPACT Improving Flow through ED Community:
I have never seen a documented national benchmark on this but my benchmark is 60 min (30 decision to bed assign and 30 bed assign to departure). I would not have a system that requires mandatory written admit orders before the patient leaves the ED. This will greatly impair flow. Phone orders are fine. Service demands of hospitalists should be required as a part of inpatient flow.
Jody Crane
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Total Posts: 2
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Re: Time from ED to Inpatient Bed (median)
3/29/2009 7:29:00 PM
Our hospital uses TeleTracking which gives us a request time (time bed is requested), ready to move time, and time patient occupies the bed. Some other times are also included but are related to housekeeping.
So, given this and your comments would you then suggest ready to move to occupy as the data to benchmarking?
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Total Posts: 2
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Re: Time from ED to Inpatient Bed (median)
3/31/2009 10:26:09 AM
(Courtesy of Faculty Member, Dr. Joseph Crane):
This ready to move time is tricky for teletracking as it is somewhat misleading because it can easily be gamed (in favor of the ER). For instance, if the ED is ready to move, it hits "Ready to move" and if there are any delays on the inpatient side, then the inpatient side is dinged. Similarly, if I am a nurse in the ER, I am going to wait until I have caught up on all of my work before I hit "ready to move" in which case, I have artificially eliminated any delay that may have been a result of the ED.
If you are able to capture
1. bed request to bed assignment (Function of beds being made available upstairs - inpatient responsibility)
2. bed assignment to ready to move (function of the ED RN being ready to deliver patient - ED responsibility)
3. ready to move to occupy bed (impossible to electronically attribute this to either side, ie inpatient RN wouldn't take report vs. ready for report, ED didn't call, but you need to keep a log of delays for each admission, especially document times report was attempted then accumulate and pareto the results and track/improve over time).
Hope this helps...
-Jody
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Total Posts: 2
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Re: Time from ED to Inpatient Bed (median)
4/6/2009 10:07:39 AM
It does, Thanks.
I do have one more question.....
Given what you said above about manipulation do you (or have even tried?) find it helpful to set specific guidelines for when to hit "RTM?"
As more and more peolpe are using RTM I am seeing that it is hit on average 9 minutes after request. It is the same for PACU and ER. I know PACU pts are not RTM in 9min when it takes an hour on average to recover.
The one consistent I have seen is the facility is Req to Occupy is running about 2-2:30, with a assign to occupy average about 1:45.
Thanks
Eric
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Total Posts: 2
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Re: Time from ED to Inpatient Bed (median)
4/9/2009 4:33:34 PM
(On behalf of Dr. Crane)
I think this is an issue you all will have to agree upon organizationally.
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