'Sense of urgency' helps sell staff

One of the keys to getting staff onboard with the new Physician in Triage (PIT) program in the ED at Parma (OH) Community General Hospital was creating a sense of urgency, says Dawn Beljin, RN, director of emergency services.

Jesse DiRando, MD, FACEP, and Beljin held meetings at which they let staff members know the patient satisfaction scores were in the 30th percentile, as well as the rates for patients who left without treatment (LWOT) — 4.8% — and length of stay (LOS) — 293 minutes. "We said, 'Look, this where we're at, this is what's happening, and by implementing doc in triage, we will improve all of these numbers — and also help throughput,'" Beljin says.

This sense of urgency "gained their buy-in," she says. Obtaining staff buy-in was accompanied by a philosophy of open communication. "We used e-mail, rounding, and additional staff meetings to explain why we were committed to the process," Beljin says.

To prepare the nursing staff for the pilot program, she first met with all the charge nurses. "We looked at the process and the environment, discussed what supplies would be needed up front in order for them to do their jobs," Beljin explains. "Then, we flowcharted the process from beginning to end."

Throughout the process, "We listened to them," she says. "We asked what was going well, and what was not going so well, and whether they needed anything they didn't have."

Adjustments had to be made along the way, Beljin reports. "We were ordering exams up front in the triage area, and all of a sudden we realized radiology did not know where these patients were," she recalls. "I talked with the director of radiology and gained her support." Now, Beljin says, radiology comes over to get patients from the waiting room and returns them there after their tests are performed.


For more information on gaining staff buy-in, contact:

  • Dawn Beljin, RN, Director of Emergency Services, Parma (OH) Community General Hospital. Phone: (440) 743-4611.