Date of Conferral

2-10-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Anna Hubbard

Abstract

Throughput widely affects all healthcare organizations. The patient care quality gap centers on throughput because poor flow and boarding causes overcrowding, leading to adverse outcomes and mortality. The practice-focused question was: How can the hospital throughput be improved to help prevent adverse effects when boarding in the emergency room (ER) for a long period of time? This process improvement project was implemented by multidisciplinary teams who addressed barriers in patient flow in real-time. The implementation stage showed boarding time in August of 2025 of 4,275 minutes to October 2025 of 2,545 minutes. The throughput performance trending scorecard of the metrics of ready to move (RTM) to assigned bed with the goal of less than 15 minutes were: August 2025 of 142 minutes to October 2025 of 148 minutes, transport response time with the goal of less than 15 minutes showed for August 2025 of 24 minutes to October 2025 of 24 minutes, and the confirmed discharge compliance for August 2025 was 88% to October was 89%. This gap was mitigated by identifying barriers and improving patient flow by focusing on emergency department (ED) boarding times, transport times, and timely discharge orders, which are shown in the descriptive and comparative analyses. Patient implications are early inpatient discharge, faster transport, and enhanced safety and satisfaction. Improving throughput promotes equitable and timely care; prevents health disparities; and supports a safer, more inclusive experience that may harm marginalized patients.

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