Webinar: Testing Emergency Department improvements with simulation – a quality improvement perspective

Amanda Peterson was tasked with using SIMUL8 to investigate the feasibility of implementing a dedicated pharmacy technician into the Emergency Department to collect medication histories during peak hours.

Inaccurate medication histories present a serious safety concern for patients and health care organizations. Previous studies suggest that a little less than half of medication histories collected contain errors (e.g. incorrect dosage, omissions, etc.), of which, about a fifth have potential to cause the patient harm. National best practices for collecting medication histories have yet to be determined.

Because collecting an accurate account of a patient’s medication history may influence their treatment and provides the foundation for medication reconciliation, hospitals have been working to identify local best practices. Unfortunately, many of these interventions target large medical centers and teaching hospitals and may not be feasible for smaller, rural hospitals, such as Vidant Duplin Hospital.
 

For this project, Raul Medina used SIMUL8 to determine how many additional patients the ED could handle without exceeding a 2% LWOT rate with existing staff and space.

Locally, rural hospitals have seen an increase in Emergency Department (ED) utilization over the past decade. Vidant Duplin Hospital is not only seeing an increase in the number of patients presenting to the ED, we are also seeing an increase in patient acuity.

As the number of ED visits and acuity increases, there is a risk of increasing the rate at which patients leave without treatment. The current national benchmarks for ED LWOT rate is less than or equal to 2%. Vidant Duplin Hospital has maintained a yearly LWOT rate of less than 2% for the last 3 years.