Team Go! Improve the Flow: Interprofessional Collaboration to Improve Communication in the Emergency Department

Project Topic:

Interprofessional collaboration to improve communication

Hospital, City and State:

Los Angeles General Medical Center, Los Angeles, California

Unit:

Emergency Department (ED)

CSI Participants:

• Asuncion Guba, RN
• Claudia Quezada, BSN, RN, MICN
• Patricia Rojas, MSN, RN, PHN
• Ershad Wali, BSN, RN

Project Goals/Objectives:

1. 75% staff compliance with CTGo process and charge nurse handoff communication form
2. Decrease staff turnover rate 2%
3. Increase collaboration and communication between staff and physicians

Project Outcomes:

1. Decreased nurse turnover rate 7% (46 to 16)
2. Developed CT order prioritization filter
3. Increased HWEAT True Collaboration score from 2.92 to 3.59
4. Increased AACN Healthy Work Environment Assessment Tool (HWEAT) aggregate score from 3.29 to 3.59 and all other standards
5. Implemented a charge nurse handoff form
6. Increased communication, rapport and continuity of care
7. These outcomes resulted in a positive estimated annual fiscal impact of $2,602,543.

Project Overview:

As one of the busiest EDs in the nation, the Los Angeles General Medical Center ED can be a difficult and challenging work environment. Oftentimes. working in a stressful fast-paced environment can lead to decreased morale and staff retention. In 2023, the ED turnover rate was 12.99%. In addition, in an independent survey 70% of emergency staff reported a lack of resources and support. In an effort to improve staff support and turnover rates, the CSI team focused our interventions on improving communication and collaboration in our largest pod, known as ER North.

The CSI team conducted a survey about nurses’ knowledge of the CT process and implemented nursing huddles to improve the flow of patients from the ED to CT. Another strategy to increase communication was developing a charge nurse handoff form. The CSI team also implemented nursing huddles to inform staff of safety concerns, and introduce new team members and available resources as another method to improve communication and collaboration.

There have been many positive outcomes from our project. In 2023, the ED staff turnover rate was 12.99%. Our goal was to decrease our turnover rate 2% in 2024. During this project our staff turnover rate decreased 7%. In addition, these outcomes resulted in a positive estimated annual fiscal impact of $2,602,543. Another positive outcome from our work includes building a sense of unity and accomplishment after each huddle. Last, novice charge nurses are able to develop leadership skills and confidence.