The 43-bed emergency department at Atrium Health Carolinas Medical Center transformed from traditional shared governance to a professional governance model that empowers front-line

Atrium Health Carolinas Medical Center- Adult Emergency Department

nurses to lead change. Nurse-led committees focused on key clinical priorities such as chest pain, stroke, sepsis, professional development and pressure injury prevention. Outcomes included improvement in ECG completion within 10 minutes from 47 percent to 77 percent, SEP-1 compliance increasing from 16 percent to 60 percent and a reduction in ED-acquired pressure injuries from seven cases per quarter to only one case by Q4 2025. These results demonstrate the impact of frontline engagement on patient outcomes and professional growth.

The department also established a comprehensive workplace violence prevention strategy centered on early identification, standardized interventions and a culture of safety. Implementation of the STAMP screening tool, enhanced security workflows and multidisciplinary collaboration reduced teammate injuries from 27 incidents in 2022 to nine in 2025. Simultaneously, staff perceptions of psychological safety improved significantly, with nurses reporting increased confidence in speaking up and contributing to decision-making. This commitment to safety has strengthened both workforce wellbeing and the delivery of high-quality patient care.