The Winter Park Emergency Department implemented an innovative nurse-led throughput initiative that restructured staffing assignments to a 1-to-3 nursing ratio during peak volume hours. The initiative improved door-to-provider time from 19 to 13 minutes; door-to-discharge time from 191 to 176 minutes; admit decision-to-departure time from 90 to 72 minutes; and overall door-to-departure time from 305 to 273 minutes. Nurses reported increased bedside presence, improved workflow efficiency and enhanced patient-centered care. The model also improved staff engagement and retention to transform a historically difficult-to-fill shift into a highly sought assignment which became permanent in 2026.

The team at the 41-bed ED also focused on reducing the rate of patients who left without being seen through process changes designed to improve patient flow and timely access to care. These efforts contributed to a left without being seen rate of a sustained 0.4 percent for 2025, down from 0.5 percent in first and second quarters of 2024. This performance reflects the department’s commitment to patient access, timely care delivery and continuous improvement led by front-line emergency nurses.