Based on the options listed list below: create solution sets to determine what the best process would be for your emergency department. create solution sets using the Pugh Matrix in the resources tab to determine what the best process would be for your emergency department.
Once chosen, create a new process map based on your chosen process.
Please include all of your documentation for choosing the solution.
For class purposes the following solution was chosen:
1. Patient taken straight back to bed upon arrival
2. Triage nurse and ED nurse do team assessment
3. Physicians use display board to see when patient arrives
4. Physician goes to patient room ASAP
5. Triage nurse assists with tasks if no new patients
6. When ED rooms are full, begin protocol process to start orders at point of arrival when available
7. When room becomes available patients are brought back to have final evaluation and treatment from physician
Video Link: https://www.youtube.com/watch?v=SukEghpo9ig
The following workflows were developed:
Rooms available flow:
Rooms full flow:
Options listed list :
For standardization we will have all students focus on the arrival of patients.
Once it was determined that we needed to focus on the arrival process for patients. A quick fix, with the clipboard removal was identified. The clipboards as an indicator of a process step was removed. It was replaced with an electronic tracker which was already available, but not used appropriately.
The team went to visit other emergency departments to see how their processes worked and looked for ways to improve our own processes by viewing others.
Hospital A has patients has patients go directly to a room when available. The triage nurse asks their normal questions and then hands off to their ED nurse. The hand off includes a conversation about the information gathered from the patient upon assessment.
Hospital B always takes patients back to rooms. They have a large amount of rooms for the volume of patients they actually see. They dont have a triage nurse, they use only the nurses who are assigned patients. If by chance they do run out of rooms, they will pull stable patients out of rooms and place them in the waiting room for further treatment.
Hospital C starts patients out by having the patient see a triage nurse. The triage nurse places orders for the patient via standardized protocols signed off by physicians. This allows the nurse to begin the process of obtaining labs, x-rays, and providing some medications. These protocols are setup and based on patient symptoms. For example, if a patient arrives with an ankle injury the nurse can order an x-ray and an anti-inflammatory medication before they see a physician. They stated it often takes a long time to develop these protocols and they dont have protocols for every symptom. Most of their protocols are for non emergent patients.
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