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EMERGENCY ROOM OF THE FUTURE Group 3 Chung-Lun Kua, Brandon Thompson, Sue Bhat Hallway Beds Ambulance Diversion Records Management September 23, 2008 Hallway Beds Observations 4 patients in the hallway 12 total hallway bed stations Typically reserved for low acuity patients

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EMERGENCY ROOM OF THE FUTURE

Group 3

Chung-Lun Kua, Brandon Thompson, Sue Bhat

  • Hallway Beds

  • Ambulance Diversion

  • Records Management

September 23, 2008


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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 Future

Group 3: Brandon, Chung, Sue


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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 Future

Group 3: Brandon, Chung, Sue


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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 Future

Group 3: Brandon, Chung, Sue


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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 status

HS 8803: Emergency Room of the Future

Group 3: Brandon, Chung, Sue


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Ambulance Diversion

HS 8803: Emergency Room of the Future

Group 3: Brandon, Chung, Sue


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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 Future

Group 3: Brandon, Chung, Sue


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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 Future

Group 3: Brandon, Chung, Sue


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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


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