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Emergency Department Throughput: Strategies for Success

Scrofine, Sharon MSN, RNC; Fitzsimons, Virginia EdD, RNC, FAAN

JONA: The Journal of Nursing Administration: July/August 2014 - Volume 44 - Issue 7/8 - p 375–377
doi: 10.1097/NNA.0000000000000085
Departments: Spotlight on Patient Care

Emergency departments are facing challenges that affect their operation such as overcrowding, boarding of admitted patients, poor outcomes due to extended waiting times to see a physician, difficulty meeting patient satisfaction benchmarks, and surges in patient census and acuity. Processes and procedures must be reviewed for effectiveness and dissected for obstacles to survive and flourish in the face of these challenges. In an effort to improve patient satisfaction, decrease waiting times, improve clinical care, and decrease lost revenue from patients leaving without treatment, several methods were investigated and implemented at the Ocean Care Center, New Jersey’s 1st satellite emergency department. Innovations included immediate bedding, optimizing use of point-of-care testing, utilizing midlevel providers, utilizing protocol orders, and using nontraditional beds.

Author Affiliations: Assistant Nurse Manager of Emergency Services (Ms Scrofine), Meridian Health Systems, Brick; and Program Coordinator (Dr Fitzsimons), School of Nursing, Kean University, Union, New Jersey.

The authors declare no conflicts of interest.

Correspondence: Ms Scrofine, 208 Veronica Dr, Brick, NJ 08724 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins