As Emergency Departments (ED) continue to fill and become crowed, the attention to care of each patient can be delayed or missed. Back flow into the ED can cause a bottleneck effect for patients coming in, which can lead to an increase in the number of patients who leave without being seen (LWBS). In order to combat the challenges of patient throughput that result in patients leaving prior to care, I am proposing the implementation of a provider in triage (PIT). By placing a provider, either physician or mid-level practitioner, in the triage area will allow patients to been seen and assessed faster. Once a patient is seen and orders are placed, care can be initiated. In addition, seeing patients at a faster rate will also help with the identification of the critically ill. Not only will the PIT be able to start orders, but a rapid assessment of patients will help acutely ill patients get out of the lobby. The goal is to see patients and have care started faster in order to avoid patients leaving without care, as well as provide better patient outcomes. Patients who leave before care can be initiated, increase both their risk for morbidity and mortality (Shah et al., 2020; Sember et al., 2021). Jesionowski et al., (2019) describes a statistic suggesting the LWBS rate for all ED visits in 2014 equated to 1.2%, which is equivalent to about 2.68 million patients. This not only increases the risk to the patient, but it can be detrimental to hospital revenue as well.

Date of publication

Fall 12-4-2023

Document Type

MSN Capstone Project



Persistent identifier



Masters of Science in Nursing Administration

Included in

Nursing Commons