EMERGENCY ROOM OF THE FUTURE

Group 3Chung-Lun Kua, Brandon Thompson, Sue Bhat

September 23, 2008

Hallway Beds Ambulance Diversion Records Management

Hallway Beds

Observations 4 patients in the hallway 12 total hallway bed stations Typically reserved for low acuity patients Beds filled by order of arrival Lack of electrical outlets Medical carts not linked to nursing station Patients have to be moved out of rooms

into hallway sometimes

HS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

Hallway Beds

Issues Patient privacy

Patient liaison receives higher complaints from hallway beds in front of nursing station

Patients must be moved for sensitive screening

Nurse privacy Noise level in the hallway Family crowds hallway – nowhere to sit

HS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

Ambulance Diversion

Observations Emory uses eRESCUE

Requests help from Hospital Attempt to reduce diversion

Criteria is hospital specific EMS can still deliver patients EMS – patient chooses hospital

regardless of diversion

HS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

Ambulance Diversion

eRESCUE Criteria (need 2 or more triggers) All beds full & > 12-15 patients in waiting

room Holding 2 or more patients for ICU Holding > 4-6 patients for bed assignment Level 2 acuity patients in waiting room Total ED volume > 45

Diversion Criteria eRESCUE insufficient to decompress ED

saturation statusHS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

HS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

Records Management

Observations Emory uses Electronic Record System

Able to access electronic medical records Patient status available to all nurses Can track lab status

Data entered by: Admin, Triage, ER nurse, MD

EMS provides a paper registration form Meds can be ordered electronically

HS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

Records Management

Issues Electronic Record System

Unable to pull electronic records from other hospitals

EMS registration must be entered manually

EMS provides a paper registration form Patients’ registration papers must be

entered manually (why not let patients enter their own data into the computer?)

HS 8803: Emergency Room of the FutureGroup 3: Brandon, Chung, Sue

Observation References

Emory Crawford Long Emergency Department

Valorie Sweigart, RN, ER Nurse Director Donna McCloud, RN, ER Charge Nurse Candice Dickson, ER Clerk Marjorie Bolton, ER Patient Liaison