296: Workflow and Quality Improvements Using Wall-Mounted Ultrasonography Machines In Pelvic Exam Rooms of a Busy Emergency Department

To assess possible improvement in patient flow and delivery of care by utilizing dedicated wall-mounted ultrasonography machines in pelvic exam rooms at a busy county emergency department. The design of this study was to collect data on patient flow through pelvic exam rooms in the emergency department where ultrasonography machines had been mounted on the walls for ready access and examinations. Data was collected from three sources. Survey data was collected for both patients and physicians from the same encounter gathering each person's opinion on privacy, quality of image, quality of care, and perceived improvement in flow over portable ultrasonography machines requiring transport into the dedicated rooms. Then time data was collected from each corresponding electronic medical record to compare to patient in department times from one-year prior who received transvaginal emergency ultrasonography exams in the department. After collection of the patient flow data was analyzed for confidence intervals and any significance of difference from one-year prior. Survey data was tabulated and charted for interpretation. Survey data demonstrated that 50/57 patient respondents felt the machines expedited their care while 55/57 felt their privacy was maintained as well. Additionally, 30/57 patients had previous ultrasonographys in an emergency department and 15/30 felt this process of having the machines in the room provided a better experience. Of 56 physician respondents, 54 preferred the wall-mounted machines with 41/56 finding the image quality “very good,” 12/56 stating “adequate” images, and 3/56 stating “inadequate” image quality. Lastly, 46/56 physicians found the machines expedited patient care. Time data showed the following median total time in the department was 3 hours, 22 minutes (95% CI: 0.023) with median medical decisionmaking time of 3 hours (95% CI: 0.023). These were compared to one-year prior where median total time in the department was 3 hours, 57 minutes (95% CI: 0.023) and median medical decisionmaking time was 3 hours, 40 minutes (95% CI: 0.023). Wall-mounted ultrasonography machines showed improved physician- and patient-perceived quality of care and patient flow as compared their experiences without. More so times for patients in the department and expedition of decisionmaking were reduced significantly by the use of wall-mounted ultrasonography machines.