Home >

How Can I Get Buy in for Bedside Registration in the Emergency Department (ED)?

Question

Let me first say my staff is great! I just cannot seem to get the buy in on bedside registration in the ED. Thanks for any suggestions you may have.

Answer

First, ask the ED Satisfaction Team or the nursing staff who do not see value in bedside registration to “secret shop.” Have them be patients and walk your front-end process and see how many times they must stand and sit before they get to an ED bed. Without bedside registration this is sometimes five to seven times!

Second, if an ED staff doesn’t move patients in a timely fashion, a “log jam” develops, which creates crisis. What is your door-to-bed time or your door-to-doc time? Measure this and estimate how much time you could cut off by doing bedside registration.

By doing bedside registration, and potentially cutting 10-20 minutes from your treat and release turnaround time for each patient, you have gained additional bed time and created virtual space. You probably already do bedside registration for ambulance patients, and it is an easy step to expand to all patients.

Third, you might try bedside registration with one individual or one shift before moving it to the entire department.

And finally, I would ask you if you are doing full registration before a medical screening exam is done. Remember, a medical screen determines if an emergency medical condition exists, and under EMTALA, insurance information is not requested until after this is done. Most EDs do not see bedside registration as a choice, but a necessity in complying with EMTALA regulations.