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Nursing Student Erin Higley CAPS’18, GS’18 Revolutionizes Clinic Triage Process

Erin Higley CAPS’18, GS’18

Nurse Erin Higley CAPS’18, GS’18 might still be a student, but she’s already inspiring change at the gastroenterology and liver clinic where she works.

“I had been an expert in my previous specialty,” says Higley, who recently transferred into one of two positions previously filled by veteran nurses at the relatively small clinic. There was a learning curve to switching specialties, and protocols weren’t well-documented, so she noticed unnecessary delays in getting patients the care they needed. “There was nothing written as far as education for new nurses—I couldn’t open a manual and see what lab values to look at or what was important for each kind of patient. With the urgent nature of some of these cases, it’s really important to be able to pull out lab values and quickly, safely pull patients in—with less backlogs.”

Patient surveys confirmed her observations; just over half said they had gotten in to see a doctor as quickly as was needed. So for her Clinical Care Change Project (CCCP) in an adult undergraduate nursing course at Bethel, Higley took it upon herself to address the problem. She developed seven algorithms for triaging patients, with a project goal of improving safe and timely access to the right care provider and right location—GI lab versus clinic—based on a patient’s diagnosis or symptoms. She hoped to decrease the average triage timeline to under 72 hours from referral, with a goal of 80 percent adherence to the algorithms’ guidelines. Specific flowcharts would aid nurses in quickly and objectively getting patients where they needed to go.

Things went according to plan. After implementing the new process at the clinic, 90 percent of referrals were triaged within two to three business days—a significant improvement over previous numbers. The average time to review a referral decreased from 35 to 19 minutes, and triage nurses reported a higher level of confidence in the safety and efficiency of triage. Errors in scheduling went from 23 percent to under one percent.

“When you do your project plan, it helps you think through how you can make a difference and apply your learning to the workplace,” Higley says, also noting that she has been able to put things she learned in class into practice immediately. That real-world connection added immediate value to her classroom experience—and helped her retain and process new concepts more easily. “You really couldn’t do this class without being employed.”

Associate Professor of Nursing Krista Hoekstra agrees. “[The CCCP] is a culmination of all the bits and pieces of the program—leadership, change, and project management. It’s really where the rubber hits the road,” she says. “We encourage students to think about their places of employment and ask, ‘What doesn’t work? What drives them crazy? What do they want the chance to fix?'...Then they look back on the project and reflect and have a chance to make changes—asking, ‘did it actually work? If not, how do I make it better?’”

Higley came to Bethel planning to complete a bachelor’s degree in nursing. Since she already had a bachelor’s in marketing—and an associate’s in nursing which met many specific requirements—she was advised to enroll in the nursing “bridge” program to take a few undergraduate-level prerequisite courses and then continue into Bethel’s master’s program for nurse educators, explains Hoekstra. Higley will receive two degrees—a bachelor’s and a master’s—when she graduates in 2018.

Higley, who will be 50 at commencement, is married with three boys. She works four days a week on top of a jam-packed family schedule, so Bethel’s part-time, flexible classes worked well for her life and career. Higley is exactly the type of busy student Hoekstra loves to serve—and she hopes that Bethel will continue to equip nurses like Higley who are confident in their skills and ready to make a difference.

“In nursing, there’s so much red tape everywhere. You can’t breathe at some of these institutions without signatures. But once you have little successes under your belt, you think ‘I can actually do this. I can make a difference,’” says Hoekstra. “That’s when our program has succeeded beyond words.”

Find out more about Bethel’s nursing programs.

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