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Split-Flow Model of Patient Care

Split-Flow Model of Patient Care

What is Split-Flow?

The Split-Flow model of care is an evidence-based best practice that hospitals nationwide are adapting with the goal of shortening the time before a patient is seen by a physician or care provider, as well as the overall length of time spent in an emergency department visit. Long-wait-times during an emergency department visit are a major reason for low patient satisfaction scores and increase the potential of a patient leaving before receiving medical care. Split-Flow represents the commitment at St. Mary to provide the highest standards in quality care.

How does Split-Flow at St. Mary work?

Using the Split-Flow Model of care, patients are first seen by a nurse immediately upon entering the Emergency Department. The nurse will make an initial evaluation and directs patients to Pediatric, Prompt Care, Acute Care, or an Expedited Treatment Area (ETA). Prompt care is for minor injuries or conditions, such as a sprained ankle or flu; and acute care is for those with severe illness or conditions who are likely to be admitted to the hospital. Pediatrics, Prompt and Acute care are most familiar to people using emergency services and it is the commitment to getting them seen by a physician within a remarkably reduced time frame that is part of the new restructuring process in the St. Mary emergency department.


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In the Split-Flow model, patients are first seen by a nurse immediately upon enterering the Emergency Department

What does Expedited Treatment Area (ETA) mean?

The Expedited Treatment Area is a resource-intense process in which evaluations, studies and tests are quickly done, and the patient moves to a comfortable environment to await results and treatment decisions. Here, an emergency physician, registered nurse, medical technician and unit clerk work as an integrated team to efficiently evaluate patients whose medical conditions require more information before a diagnosis and course of treatment can be decided.

Why is St. Mary Implementing Split-Flow?

The Split-Flow Model is designed to parallel process triage and registration, have patients seen by a provider as quickly as possible, and to effectively manage patients based the severity of their conditions. The experienced nurses who first greet a patient upon their arrival to the Emergency Department at St. Mary use the guidelines of the Emergency Severity Index recommended by the Emergency Nurses Association to quickly determine the anticipated level of care needed by the person seeking treatment. An Emergency Department Pilot Technician then guides the patient to the appropriate treatment area to facilitate the care process. The intent is to redirect the wait time for results rather than waiting to be seen by a care provider.

What will Split-Flow and the greater expansion of the Emergency & Trauma Departments mean for our patients in the future?

In 2011, St. Mary treated nearly 69,000 patients in its current Emergency Department designed for a capacity of 50,000. While experiencing double-digit growth in the Emergency Department in each of past three years, patient satisfaction scores remain in the 90th to 95th percentile. The new expansion and redesign will provide the ability to care for up to 100,000 people annually – nearly double the current capacity – to help meet the increasing need in the region for prompt and advanced emergency care.