To Admit or Not to Admit: Emergency Department Discharges After Request for Medicine Admission.

Background: The decision to discharge versus admit a patient from the emergency department (ED) carries significant consequences to the patient and healthcare system.

Methods: We evaluated all ED visits at a single facility from January 1-December 31, 2015, where the ED provider initially requested admission to medicine; however, following medicine evaluation, the patient was discharged from the ED.

Results: 8.

Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions.

Background: The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored.

Using lean management to reduce blood culture contamination.

Background: Blood culture contamination (BCC) is a common and avoidable complication of patient care and incurs considerable cost. A quality improvement (QI) initiative was undertaken at a large Department of Veterans Affairs (VA) medical center to reduce the BCC rate.

Methods: Lean management QI methods, including a rapid process improvement workshop (RPIW), were used to identify root causes of variation in blood culture procedures and countermeasures (potential improvement strategies) to address each problem were developed.