How is the group process and team building effected by the organization’s culture and climate of transparency and safety?

You are the unit director of the emergency department and part of an ad hoc interdisciplinary committee newly formed to address a 30% rise in arrival-to- provider time over the past six months. Six months ago, the ED consistently recorded an arrival-to-provider time less than the national benchmark of twenty minutes. The arrival-to-provider time is presently over one hour. A root cause analysis study finds that arrivals to the ER have increased by 50% and the lobby is usually filled to capacity. Often patients must stand due to lack of adequate seating. FTEs have not been added and staffing is consistently short due to call-offs. Patients are not being discharged from inpatient beds in a timely manner. The task for the committee is to propose a solution for the problem.

1. Looking at this through the lens of an evidence-based quality improvement process, what would you propose as the PICOT for this initiative?