Washington Regional Medical Center Emergency Department

Fayetteville, Arkansas

The Washington Regional Medical Center ED team successfully implemented a process to ensure arrival-to-antibiotic administration for open fractures within one hour. It set clear goals to order within 15 minutes of patient arrival, leaving the RN 30 minutes to administer the antibiotic. The entire team — including ED physicians, trauma surgeons, trauma team, charge nurses, pharmacists and front-line ED nurses — took ownership of the project to ensure IV pumps and pre-mixed antibiotics were always immediately available and checked frequently, as well as provide staff feedback and praise for wins. The ED exceeded its goals with 100 percent compliance.

Additionally, the ED leadership team developed a task force to address workflow issues that were revealed in a staff satisfaction survey, including improving delegation, optimizing roles and fundamentally redesigning workflows. To help address bottlenecks that could place more work on a few employees, a flow coordinator was introduced assist with tasks and ensure RNs, paramedics and techs were placed in the most optimal areas depending on the needs of the department in real time. These changes transformed a cultural opportunity from a staff survey into a clear victory that resulted in improvement in staff satisfaction and reduction in turnover.