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{
    "pk": 10868,
    "title": "A Novel Approach to Addressing an Unintended Consequence of Direct to Room: The Delay of Initial Vital Signs",
    "subtitle": null,
    "abstract": "Introduction:\n The concept of “direct to room” (DTR) and “immediate bedding” has been described in the literature as a mechanism to improve front-end, emergency department (ED) processing. The process allows for an expedited clinician-patient encounter. An unintended consequence of DTR was a time delay in obtaining the initial set of vital signs upon patient arrival.  \n \nMethods:\n This retrospective cohort study was conducted at a single, academic, tertiary-care facility with an annual census of 94,000 patient visits. Inclusion criteria were all patients who entered the ED from 11/1/15 to 5/1/16 and between the hours of 7 am to 11 pm. During the implementation period, a vital signs station was created and a personal care assistant was assigned to the waiting area with the designated job of obtaining vital signs on all patients upon arrival to the ED and prior to leaving the waiting area. Time to first vital sign documented (TTVS) was defined as the time from quick registration to first vital sign documented.\nResults:\n The pre-implementation period, mean TTVS was 15.3 minutes (N= 37,900). The post-implementation period, mean TTVS was 9.8 minutes (N= 39,392). The implementation yielded a 35% decrease and an absolute reduction in the average TTVS of 5.5 minutes (p<0.0001). \nConclusion:\n This study demonstrated that the coupling of registration and a vital signs station was successful at overcoming delays in obtaining the time to initial vital signs.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Vital Signs, Direct To Room"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6gz2w02c",
    "frozenauthors": [
        {
            "first_name": "Joseph",
            "middle_name": "",
            "last_name": "Basile",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        },
        {
            "first_name": "Elias",
            "middle_name": "",
            "last_name": "Youssef",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        },
        {
            "first_name": "Bartholomew",
            "middle_name": "",
            "last_name": "Cambria",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        },
        {
            "first_name": "Jerel",
            "middle_name": "",
            "last_name": "Chacko",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        },
        {
            "first_name": "Karyn",
            "middle_name": "",
            "last_name": "Treval",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        },
        {
            "first_name": "Barry",
            "middle_name": "",
            "last_name": "Hahn",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        },
        {
            "first_name": "Brahim",
            "middle_name": "",
            "last_name": "Ardolic",
            "name_suffix": "",
            "institution": "Northwell Health, Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York",
            "department": "None"
        }
    ],
    "date_submitted": "2017-06-03T17:13:31-04:00",
    "date_accepted": "2017-06-03T17:13:31-04:00",
    "date_published": "2018-02-19T13:10:51-05:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/10868/galley/5900/download/"
        }
    ]
}