- AdventHealth
As the town of Parker and surrounding communities keep growing, AdventHealth Parker’s emergency department is getting busier. Every year, the ED has experienced an increase in patients, and an increase in the seriousness of patients’ illnesses and injuries.
To help manage the growth, the ED recently implemented rapid assessment zones in October 2024 to improve throughput and decrease the number of people who left without being seen.
“Reimagining the triage process with front line nursing input was vital to the success of this project,” said James Sandoval, MSN, RN, CEN, Director of Emergency Services. “We also engaged with multidisciplinary committees such as the ED patient experience council, radiology services committee, ED providers, and front-line staff members.”
Following those meetings, the ED decided to switch from a traditional triage process to a rapid assessment zone (RAZ). Once patients are triaged into the emergency department, they go to an intake room where they are seen by the RAZ nurse and provider. IVs, labs, and medications are given as needed, and then the patient is moved to a treatment lounge.
From there, imaging and other departments can come and retrieve patients for additional testing and return them to the lounge area. The RAZ RN stays in close communication with the triage RN and charge RN, and together they work to move patients who need additional monitoring to a room once one becomes available.
“Patient experience was top of mind when designing this process,” said James. “By talking with nurses and providers from other hospitals who had implemented rapid assessment zones, we learned how vital it was to have a clear understanding of the process for patients.”
That’s why the ED worked with marketing and supply chain to create a video for patients that is played on iPads in the intake room. An education program was also developed to train all ED nurses and critical care technicians in the new process.
“This initiative gets the patients in front of a provider quickly, so we have the right orders at the right time, expediting our process,” said James.
Since the rapid assessment zone was implemented in October 2024, the amount of time the ED has had to go on divert has dropped from 29 hours on average per month to only nine hours. The amount of time between a patient’s admission and disposition decreased by an average of 12 minutes. The amount of time from when a patient was admitted to when they saw a provider decreased by an average of six minutes. Since October 2024, the average percentage of patients who left without being seen is down to 0.53%, well below the department’s goal of less than 1%.
“I am encouraged by the great success we have already seen by implementing the rapid assessment zone. It has helped us stay open for our community,” said James.
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