Developing a Staff-Led Vertical Flow Model Policy in a Rural Emergency Department
Project Abstract
Introduction: Emergency department (ED) overcrowding contributes to prolonged wait times, increased mortality, and staff burnout. The Vertical Flow Model (VFM) was developed to improve patient flow and has demonstrated reductions in length of stay, door-to-provider time, and rates of patients leaving without being seen. Although adaptable to different ED settings, implementation has primarily occurred in large, urban hospitals. This project aimed to develop a staff-led policy for a modified VFM tailored to a small, rural ED.
Methods: An anonymous survey was distributed to ED staff to assess perceptions of current patient flow and perceived areas for improvement. Survey data were analyzed using descriptive statistics and used to guide the development of a modified VFM policy. The proposed policy was submitted to ED leadership for review and revised based on feedback.
Results: Nearly 75% of participants rated the current patient flow as 3 or lower on a 5-point Likert scale. Participants identified reducing door-to-provider time as a key factor to improve patient flow. Major barriers included the increasing patient volume and delays in orders and discharge processes.
Conclusion: A modified VFM policy was developed using the waiting room as the Vertical Flow Area and revised due to limited provider availability to include protocol orders in triage. The revised policy was accepted by ED leadership, demonstrating that the model can be successfully adapted in small, rural EDs.
Conference
Kentucky Association of Nurse Practitioners and Nurse Midwives Annual Coalition Conference
Dates: April 15th-17th, 2026
Location: Crowne Plaza Louisville Expo Center
Sponsoring Body: Kentucky Association of Nurse Practitioners and Nurse Midwives
Conference Website: https://www.kcnpnm.org/page/conference
Funding Type
Travel Grant
Academic College
School of Nursing and Health Professions
Area/Major/Minor
Nursing
Degree
Doctorate of Nursing Practice
Classification
Graduate
Name
Jennifer Rogers, APRN, DNP
Academic College
School of Nursing and Health Professions
Recommended Citation
Frankland, Grace and Rogers, Jennifer, "Developing a Staff-Led Vertical Flow Model Policy in a Rural Emergency Department" (2026). ORCA Travel & Research Grants. 249.
https://digitalcommons.murraystate.edu/orcagrants/249
