As a nurse on the Zayed 8 labor and delivery unit at Johns Hopkins Hospital, Nikki Bellamy worried that sick mothers and babies sometimes waited too long to see a nurse or doctor. .
“When we were particularly busy, we had patients sitting in the waiting room for eight hours without seeing a healthcare professional,” she says. “So we had near misses, and I just felt we needed a safer practice.”
Bellamy expressed his concern to Susan Will, an obstetrics patient safety nurse. “And Susan, who is my mentor and my heroine, said, ‘OK, let’s get together and think.’ At the end of 2014, they formed a committee.
It took nearly five years of research, testing and data collection, but the new system, which includes the use of a well-tested obstetrics triage acuity tool, was fully adopted in 2019. At Instead of patients checking in with security and registration while an invisible nurse assigns rooms, there is now a dedicated triage nurse who assesses each patient prior to check-in. This nurse also reassesses patients at prescribed intervals. Patient wait times have dropped by 80%, and critical care patients are now assigned a room somewhere on the unit, even when triage rooms are full.
“Back then, our triage was first-come, first-served,” Bellamy explains. “My idea was to offer rooms and care based on the acuity or urgency of the case. And we wanted the process to be nursing-focused.
“It’s been a huge success, and our patients love it because no one feels left out,” says Bellamy, who was honored with the new Johns Hopkins Hospital Nurse Professional Practice Model Award this year. “And I’ve learned that as nurses, we can use our voices, not just to take great care of our patients, but to effect broader change.”
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