Tiered structure helps ED improve flow, satisfaction.

Abstract

Subdividing the major management tasks of one ED lightened the manager's load and gave staff a clearer idea of where to take their problems, helping to drop average length of stay from 85 minutes to 45 minutes, reduce throughput from 308 minutes to 230 minutes, and improve patient satisfaction from 74.6% to 84%. Where possible, divide responsibilities according to the talents of the individual nurse managers. A manager with ED and observation unit responsibilities improves communication between the units. Tiered staffing structure creates ready-made "team leaders" for departmentwide initiatives.