Alright, let’s build a process map (flowchart) to address the ED wait time issues at Charleston General Hospital. I’ll provide a text-based representation, which you can then translate into a visual flowchart using software like Lucidchart, Visio, or even Google Drawings.

Current Process (Inefficient):

1. Patient Arrival at ED: (Start)
2. Triage: (Decision)
   • If Urgent:
     • 3. Immediate Treatment/Stabilization: (Process)
     • 4. Registration/Insurance Verification: (Process)
     • Go to 6.
   • If Non-Urgent:
     • 4. Registration/Insurance Verification: (Process)
     • 5. Waiting Area: (Process)
     • Go to 6.
3. Physician Assessment: (Process)
4. Diagnostic Tests (Labs, Imaging): (Process)
5. Results Waiting: (Process)
6. Decision: Admission/Discharge: (Decision)
   • If Admission:
     • 7. ED Admission Hold (Waiting for Bed): (Process)
     • 8. Inpatient Bed Assignment: (Process)
     • 9. Patient Transfer to Inpatient Unit: (Process)
     • (End)
   • If Discharge:
     • 10. Discharge/Follow-up Instructions: (Process)
     • (End)
7. Patient Leaves Without Being Seen (LWBS) (If Wait is Too Long): (Process) (End)

Proposed Redesigned Process (Efficient):

1. Patient Arrival at ED: (Start)
2. Rapid Triage & Bed Availability Assessment: (Decision)
   • If Urgent:
     • 3. Immediate Treatment/Stabilization & Bed Placement (If Available): (Process)
     • 4. Express Registration/Insurance Verification (Concurrent with Triage): (Process)
     • Go to 6.
   • If Non-Urgent:
     • 4. Express Registration/Insurance Verification (Concurrent with Triage): (Process)
     • 5. Point-of-Care Diagnostic Testing (Where Applicable): (Process)
     • Go to 6.
3. Physician Assessment (Concurrent with Diagnostics): (Process)
4. Rapid Results Processing & Communication: (Process)
5. Decision: Admission/Discharge: (Decision)
   • If Admission:
     • 7. Dedicated ED Admission Holding Unit (Short-Stay): (Process)
     • 8. Inpatient Bed Assignment (Expedited): (Process)
     • 9. Patient Transfer to Inpatient Unit (Expedited): (Process)
     • 10. Bed Turnover Optimization: (Process)
     • (End)
   • If Discharge:
     • 11. Discharge/Follow-up & Bed Turnover Optimization: (Process)
     • (End)

Key Changes and Rationale:

• Rapid Triage & Bed Availability Assessment: Immediate triage and bed assignment (if available) reduce initial wait times.
• Express Registration/Insurance Verification (Concurrent with Triage): Simultaneous registration and triage streamline the intake process.
• Point-of-Care Diagnostic Testing (Where Applicable): Faster diagnostic results lead to quicker treatment decisions.
• Physician Assessment (Concurrent with Diagnostics): Concurrent physician assessment minimizes delays.
• Rapid Results Processing & Communication: Prompt communication of test results accelerates decision-making.
• Dedicated ED Admission Holding Unit (Short-Stay): A dedicated holding unit reduces ED congestion and improves patient comfort.
• Expedited Inpatient Bed Assignment & Transfer: Streamlined processes for bed assignment and patient transfer improve flow.
• Bed Turnover Optimization: Optimizing bed turnover increases availability and reduces delays.

Flowchart Symbols (for Visual Representation):

• Oval: Start/End
• Rectangle: Process/Activity
• Diamond: Decision
• Arrow: Flow of Process

Implementation Notes:

• This is a general process map. Specific details will need to be added to customize it to the specific environment.
• Data collection and analysis are vital to track the effects of this new plan.
• Training of staff is important for the success of this new plan.
• Technology solutions should be investigated to help implement this plan.

By implementing these changes, Charleston General Hospital can significantly improve ED flow, reduce wait times, and enhance patient satisfaction.