Billings Clinic Emergency Department and Level I Trauma Center
Billings, Montana
Billings Clinic Emergency Department and Level I Trauma Center
By empowering nurses to act swiftly based on clinical judgment, the Billings Clinic Emergency Department and Level I Trauma Center team created a more
responsive, efficient and collaborative emergency department.
Among its recent initiatives was the implementation and expansion of nurse-driven protocols to improve timeliness of care and enhance nurse autonomy in the 36-bed ED. Through shared governance and interdisciplinary collaboration, the ED team reviewed and revised protocols that allow nurses to initiate care—such as fluids, medications and diagnostic imaging—without waiting for provider orders. This has significantly reduced time-to-treatment for conditions including stroke, chest pain and sepsis, while also improving patient flow and satisfaction. Nurses report increased confidence and ownership in patient care, and the initiative has strengthened teamwork between nurses and providers. Ongoing education, clear documentation guidelines and regular outcome reviews have sustained the initiative’s success.
responsive, efficient and collaborative emergency department.
Among its recent initiatives was the implementation and expansion of nurse-driven protocols to improve timeliness of care and enhance nurse autonomy in the 36-bed ED. Through shared governance and interdisciplinary collaboration, the ED team reviewed and revised protocols that allow nurses to initiate care—such as fluids, medications and diagnostic imaging—without waiting for provider orders. This has significantly reduced time-to-treatment for conditions including stroke, chest pain and sepsis, while also improving patient flow and satisfaction. Nurses report increased confidence and ownership in patient care, and the initiative has strengthened teamwork between nurses and providers. Ongoing education, clear documentation guidelines and regular outcome reviews have sustained the initiative’s success.