Date of Conferral



Doctor of Nursing Practice (DNP)




Deborah A. Lewis


AbstractDue to the large influx of patients, emergency departments (ED) across the United States strive to efficiently manage and improve workflow to increase the quality of care and reduce wait times for patients who present at the ED for care. Well-organized workflow is critical to providing efficient and time-sensitive care, beginning with the Fast Track (FT) area. The FT is a designated area of the ED where lower acuity or noncritical patients are seen and treated. Improving workflow in the FT area of the ED can help lessen wait times and overall length of patient visit and improve the delivery and efficiency of care. The goal of this project is to develop an evidence-based clinical practice guideline (CPG) for use in the ED FT area to steer and improve workflow. Queuing theory, supply chain management, and the lean thinking concepts informed this project. Development of this CPG utilized the Walden CPG manual and the AGREE II tool. Three clinical experts in ED care who were also stakeholders evaluated the CPG using the AGREE II instrument. The quality score for each domain was calculated by adding all the scores for each item in each of the six AGREE II domains and scaled as a percentage of the maximum possible score for that domain. All three stakeholders graded domains one (scope and purpose) and two (stakeholder involvement) at 100%. Other domain scores ranged from 93-96% indicating high agreement with the CPG. This project has the potential for impacting positive social change by reducing overcrowding, improving patient flow, and ED workflow, staff and patient satisfaction and reduced risk of poor outcomes as a result of overcrowding in the ED.

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Nursing Commons