Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2019


Doctor of Nursing Practice (DNP)

Primary Advisor

Cathie E. Guzzetta, PhD, RN, FAAN; Patti Radovich, PhD, CNS, FCCM; Helen Staples-Evans, DNP, MS, RN, NE-BC; Qiuping (Pearl) Zhou, PhD, RN


Background: Since 2005, the Joint Commission required moving patients through the hospital quickly. Previous efforts at our hospital improved Emergency Department throughput but hospital-wide congestion of patients remained.

Objectives: To examine the effects of implementing a patient progression coordinator (PPC) on hospital length of stay (LOS) for patients with ST-elevated myocardial infarction (STEMI), ischemic stroke, knee replacement, and hip replacement.

Methods: We used a separate sample, pre- post- intervention design conducted in a southern California community hospital. The intervention was implementation of a PPC to facilitate movement of patients through the hospital. LOS, from time of admission to discharge, was measured on a random sample of 614 patients admitted with diagnosis of STEMI (n=199), ischemic stroke (n=91), hip replacement (n=198), and knee replacement (n=126) before and after the intervention. Differences were calculated for pre- post LOS using independent t-tests with significance set at 0.05.

Results:Knee replacement patients in the post-intervention group had a significantly shorter LOS (57.22 ± 14.28 hours) compared to those in the pre-intervention group (65.59 ± 16.23 hours; t=3.85, p

Conclusions: Our study demonstrated the role of the PPC was effective in reducing LOS for knee replacement patients but not for the other patient groups. It appears that the PPC has the potential to reduce LOS for other populations but further evaluation is needed.

Open Access


Included in

Nursing Commons



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