Facility: Beartooth Billings Clinic

Project Team Members (name, title): 1. Bridgett Chartier 2. Sharon Norby 3. Brandi Mains 4. Chris Benton 5. Sue King 6. Allyson Moore 7. Jessica Fink 8. Laura Way 9. Mike Nordstrom

ED Throughput Process Analyzed:

1. ED Discharge time stamp in Cerner.

Issue Statement:

1. Beartooth reviewed the encounters that had long lengths of stay in the Emergency Department. We specifically focused on the frequency of these extended stays which mostly occurred between Midnight and 8 AM. Of the 41 charts that were audited, 9 charts were found to have inaccurately recorded discharge times equaling about 22% error rate.

Implementation Results and Desired Outcomes (Actual/Projected): 1. Standardized documentation of patient departure times by Nursing staff. 2. Standardized method of recording patient departure times by Registration staff.

3. Specific training and education for new hires and ongoing education if error rates increase.

4. Updates to training manuals for standardized processes.

Next Steps:

1. Mid-May Staff Meetings for Nursing and Registration education. 2. 100% audits of the Midnight to 8 AM charts by Medical Records during daily processing.