Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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At our urban academic medical center, efforts to alleviate ED overcrowding have included the implementation of a "fast track" area, increasing the ED size, using hallway beds, and ambulance diversion. In October 2012, we began the first steps of a process that created a system in which the admission process involves equal amounts of pushing and pulling to achieve the balance necessary to accomplish optimal outcomes. The foundation of the initiative was based on the use of a BSN-educated emergency nurse as a flow coordinator; a position specifically empowered to affect patient throughput in the emergency department. ⋯ Investing in a flow coordinator program can generate improvements to patient flow and can yield significant financial returns for the hospital. A decrease in diversion by an average of 49.8 hours per month translates to an annual decrease of nearly $20 million in lost potential charges. A decrease in the LWBS rate by 1.5% (31% relative decrease) per month translates to an annual decrease in lost potential charges of more than $5 million. Our research shows that an ED flow coordinator, when supported by departmental and hospital leadership, can yield significant results in a large academic medical center and that the program is able to produce an effective return on investment.