Nancy Bonalumi

Impact of a Planned Workflow Change: Super Track Improves Quality and Service for Low-Acuity Patients at an Inner-City Hospital

Problem: ED volume and acuity were anticipated to increase at an inner‐city hospital. A strategy to mitigate the impact was needed. Methods: A multidisciplinary team facilitated a workflow modification project implementing a Super Track to treat low‐acuity patients. A literature review led to the creation of an evidence‐based framework. Staff education regarding the change process and the results of an analysis in the strengths, weaknesses, opportunities, and threat format, along with simulation exercises and a pilot project, supported implementation of this strategy. Results: Simulation exercises demonstrated that the proposed workflow with a Super Track had the potential to reduce the length of stay among level 4 and 5 patients coming to the emergency department. Implementing a Super Track reduced the patient arrival‐to‐provider time for low‐acuity patients, but length of stay was not affected. After implementation, the number of patients who left without being seen decreased by 40%, and patient satisfaction increased by 36%. Implications for practice: A modified front‐end workflow process produced a statistically significant, sustainable improvement in patient flow of low‐acuity patients in our emergency department. Use of an evidence‐based, multidisciplinary team approach supported the change process.