New Process Speeds Up Kids' Stay

From left to right: Jahn Avarello, MD, pediatric emergency; Kristy Williston, pediatric emergency fellow; and Yvonne Hernandez, pediatric emergency nurse, discuss ways to improve care in the Emergency Department.

Patients who visit the Emergency Department at Cohen Children’s Medical Center for treatment will experience shorter waiting times under a new fast-track process that allows for the speedy treatment of minor ailments.

"They will get home and back in action faster than if they went through the old process of sitting in the regular waiting room,” said Jahn Avarello, MD, the chief of pediatric emergency medicine at Cohen Children’s Medical Center.

Usually, patients who arrived in the Emergency Department were put through a triage system that ranks patients based on the severity of their condition, moving the most urgent to the top of the list. Although the triage system ensures patients in need of immediate care receive it first, less severe cases had to wait, and that wait only became longer as more and more children arrived.

With the growing volume of patients becoming the standard at Cohen Children’s, the fast-track process became the answer. The process is used during high-volume periods in the Emergency Department.

Two exam rooms were transformed into a dedicated fast-track waiting room and an area where patients could wait for pending results. The loss of exam rooms was a concern, but we had to think outside of the box, Dr. Avarello said, and the benefits to the fast-track process are immense.

“We can see more patients in the same area in much less time,” he said.

The new fast-track process is all about movement. Patients are moved from the fast-track waiting room to an examination room. After being evaluated, they are moved back to the fast-track waiting room while their results are pending. This constant movement frees up space to quickly examine other children who are waiting for care.

“When we move patients through the area instead of sitting in one room to wait for results, we’ve already cut their length of stay by 30 percent, which equates to about one hour,” said Dr. Avarello.

Patients with less severe problems were not the only ones feeling the benefits of a dedicated fast-track area. High-priority patients in the triage area also found themselves being treated more quickly than before because emergency caregivers in that area can now focus on more critical cases.

“By reducing length of stay for patients with less urgent problems, it reduces the wait for everyone. We’re able to dedicate more time to patients with higher priority needs because of the dedicated fast-track, and we’re able to give those with less urgent needs the care they deserve within an acceptable time frame,” said Dr. Avarello.

While Dr. Avarello considers the fast-track process a success so far, he still sees ways to improve and expand the program. Plans are already under way to expand the fast-track area, including doubling the hours of operation in the coming months.

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