ECG CASES COLUMNImplementation of a Standardized Protocol for Telehealth Provider in Triage to Improve Efficiency and ED Throughput A Quality Improvement ProjectFleming, Adam DNP, APRN, FNP-C, ENP-C; Whitty, Kristin PhD, APRN, FNP-C Author Information Emergency Department, Ochsner Health, New Orleans, Louisiana. Corresponding Author: Adam Fleming, DNP, APRN, FNP-C, ENP-C, Emergency Department, Ochsner Health System ([email protected]). Acknowledgments and Credits: Kenesha Bradley, CNS; Eileen Creel, DNS, RN; Charlane Liles, MD; Jeffery Kuo, MD. No funding was obtained from any sources including but not limited to: National Institutes of Health, Welcome Trust, Howard Hughes Medical Institute (HHMI); and other(s). Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (http://www.aenjournal.com). Disclosure: The authors report no conflicts of interest. Advanced Emergency Nursing Journal: October/December 2022 - Volume 44 - Issue 4 - p 312-321 doi: 10.1097/TME.0000000000000433 Buy SDC Metrics Abstract There has been a significant rise in the number of emergency department (ED) visits over the past 15 years despite the number of ED providers and treatment spaces remaining fixed (M. P. Lin et al., 2018). A hospital's need to quickly initiate care upon patient arrival is of paramount importance to combat these ED overcrowding trends. A teleprovider in triage (TPIT) program without a standardized operating protocol leads to significant provider practice variations and limits effectiveness of a TPIT program. The intention of this health care project was to reduce ED time metrics and reduce the number of patients who left before evaluation by implementing a standardized TPIT protocol. This standardization allowed for a more predictable experience for the patient and ED staff. This quality improvement project involved developing and implementing a standardized TPIT protocol to improve TPIT efficiency and throughput. Patient ED visit metrics were collected during the pre- and postimplementation periods to evaluate for any improvement in throughput due to the TPIT protocol. The TPIT advanced practice providers (APPs) showed significant improvement in knowledge following the TPIT protocol education with an increase in provider comfort (p < 0.05). Time spent by the TPIT provider on each patient encounter was reduced by 23%, demonstrating increased provider efficiency. Improvements in discharge lengths of stay (LOS) (p = 0.68) and room to discharge LOS (p < 0.05) were noted following the implementation of the TPIT protocol. Conclusions: The implementation of the TPIT protocol provided improvements in APP knowledge and understanding of the process while increasing provider efficiency. Improvements were identified in specific ED patient metrics demonstrating the significance of the TPIT protocol on patient care. © 2022 Wolters Kluwer Health, Inc. All rights reserved.