Santa Barbara Cottage Hospital Emergency Department
Santa Barbara, California
Santa Barbara Cottage Hospital Emergency Department
What began as Santa Barbara Cottage Hospital’s ED nurses pursuing ultrasound-guided IV training evolved into an innovative, hospital-wide Vascular Access Team that transformed patient care and nursing practice. Led by ED nursing leadership, the program expanded from difficult IV placement to midlines and bedside PICC insertions, supported by new policies, workflows and a dedicated cost center. In 2025, VAT nurses placed more than 500 PICCs with a 95 percent first-attempt success rate and more than 1,200 midlines which reduced delays in care and improved patient satisfaction. The team promotes nursing autonomy, provides 24/7 vascular access expertise and advances evidence-based vascular access practices across the health system.
Other improvements were the result of a multidisciplinary throughput collaborative among ED and inpatient leadership, which developed a capacity management plan, creating standardized surge and bed utilization protocols. To accelerate patient movement, a dedicated throughput supervisor role was established to coordinate real-time transfers. For front-end flow, implementing the vertical care model leveraged pivot nurses and rapid provider evaluation to reduce waiting times, which contributed to an increase in patient satisfaction scores for “Waiting Time to Treatment Area” from 70 in 2024 to 84 in 2025.