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Emergency Nurses Bring Change to How Hartford Hospital Works

Jessica Alemar has seen it all. As an RN in Hartford Hospital’s ED — one of the busiest EDs in New England — she has treated patients with broken bones, trauma, heart attacks and strokes. Her quick instincts and extensive knowledge help save lives every day.

“ED nursing has an intensity that I love. It’s amazing to know that our quick actions can make such a difference in someone’s life,” Alemar said.

Working as a nurse in the ED not only means that you help save lives, it means you can make true, meaningful change every day. With “How Hartford Hospital Works” — an operational model recently implemented at Hartford Hospital — Alemar and her colleagues belong to a group that meets regularly to discuss what works well and what changes should be considered, engaging every employee.

Jessica Alemar, RN, walks through the department’s new triage area.

When the program — called H3W for short — was first introduced to the ED, the team wanted to tackle the challenge of managing an increasing volume of patients (almost 20,000 additional patients in two years) while remaining committed to excellent patient care.

ED nurses, residents, nurse practitioners and physicians joined forces and conducted a thorough workflow map to look for better ways to work together. They also brought in other departments — including inpatient nursing, radiology, bed management, housekeeping and facilities — to look for more opportunities to improve the patient experience.

The team didn’t stop there. It visited other hospitals to learn best practices, organized subgroups, studied literature and established benchmarks. The group found many opportunities for change, including a redesign of its triage area and expansion of its front end provider rooms.

“H3W has truly transformed our Emergency Department,” said A.J. Smally, MD, medical director of emergency medicine at Hartford Hospital. “Nursing has played a critically important role in the process, offering valuable perspective on better serving our patients.”

One year later, ED capacity is already up 10 %. Five front-end provider rooms, a new triage space and a new discharge area were added. Through H3W, the team has generated more than 100 ideas, such as improving the medication delivery system, streamlining laboratory and radiology turn-around times, and considering safer and more efficient ways to transport patients within the hospital. Other ideas also are being implemented, including further expansion within the next year.

“An essential ingredient to the H3W process is leadership,” says Linda Berger Spivack RN, vice president of patient care services at Hartford Hospital. “The workgroup leader plays a crucial role in helping our culture evolve, and in making sure H3W is successful. Our leaders are our champions.”

For more information on nursing at Hartford Hospital, visit


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By | 2020-04-15T14:28:01-04:00 December 6th, 2010|Categories: National|0 Comments

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