Making more nurses, one minute at a time: an efficiency and quality improvement project in emergency triage
Intended for healthcare professionals
Evidence and practice    

Making more nurses, one minute at a time: an efficiency and quality improvement project in emergency triage

Anna Mackway-Jones Clinical academic matron, emergency department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, England
Rachael Hornby Senior sister, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, England
Kevin Mackway-Jones Director of postgraduate medicine, Manchester Metropolitan University, Manchester, England

Why you should read this article:
  • To enhance your understanding of triage processes and of the primary aim of emergency triage

  • To explore how the principles of lean management can be applied in a healthcare setting

  • To read about a project successfully conducted to reduce triage time in an emergency department

Emergency triage is a short-duration, high-volume process so small reductions in the time taken to triage one patient can have large repercussions on the total amount of triage time. At the emergency department of a large inner-city hospital, an efficiency and quality improvement project was undertaken to reduce the time taken to safely triage patients and optimise the use of triage nurses’ time. The project involved removing processes that did not contribute to the primary aim of triage, supporting individual triage nurses to improve their performance where needed, and optimising the triage process. A 44% reduction in mean triage episode time was seen, equating to 18,000 minutes of triage nurses’ time saved every month. This near doubling of triage capacity was associated with an improvement in triage accuracy. The article describes the project, which used lean management principles and statistical process control methods, and discusses its implications for emergency triage.

Emergency Nurse. doi: 10.7748/en.2023.e2127

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

@mackway_jones

Correspondence

anna.mackway-jones@mft.nhs.uk

Conflict of interest

None declared

Mackway-Jones A, Hornby R, Mackway-Jones K (2023) Making more nurses, one minute at a time: an efficiency and quality improvement project in emergency triage. Emergency Nurse. doi: 10.7748/en.2023.e2127

Published online: 05 January 2023

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