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The main goal of any work in the emergency department (ED) is getting the patient out of the ED. This could either be by discharging them home, admitting them to a medical, surgical floor, or psychiatric floor (if your hospital has one), or transferring them to another hospital for whatever specialty the patient needs that your hospital does not have.

Every provider and participant in the flow of the patient’s journey is in sync with the goal of getting the patient out of the ED. Patients are always coming into the ED, day and night—and the only way to ensure that the ED is not drowning in patients, any more than it may already seem, is to get them out. Knowingly or not, and certainly on different levels of sophistication and incentive structures, the players, from operation administrators to the patient transport technician, feel the pressure of this aligned goal.

Increased patient flow in the ED, at any one given time, increases everyone’s burden and stress, potentially leading to strained patient interactions, employee interactions, and worst of all, the potential for errors. These concerns are reflected in poor doctor-nurse communication scores, patient satisfaction scores, employee satisfaction scores, and even increased patient complaints, allegations, and law suits. Long-term burdens and stressful work environments lead to provider burnout and turnover and can spiral into a feedback loop of difficulty hiring optimal candidates, feeding into the increased burden and stress for the remaining providers.

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