Post on 08-Apr-2018
transcript
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IN AND OUT OF THE
EMERGENCYROOM
Streamlined design of patient flow
Venisha Naina D·Souza
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INTRODUCTION
The emergency department (ED) has become the ¶
front door· to the hospital.
Many institutions report that 50 percent or more
of their admission come through the ED. Many factors influence the patients throughout
in and out of the emergency department. Clarity
in layout and simplicity an operations are keys to
streamlined flow.
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FOUR MAIN AREAS TO BE COVERED
Arrival
Health record
Supply placement
Diagnosis
Discharge process
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A RRIVAL
In the hospitals it is seen that one or poorly
placed dual entrances create the chaos of
comingling of self arriving patients and with
those coming in emergency vehicles. Patients arrival to ED is distinguished as two
types
y Ambulance arrival
y Ambulatory patient or self arrival
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SUGGESTION
The optimal layout is too have distinguished
pathways for the ambulance apart from the
ambulatory.
This separation should begin at the arrival to thecampus and continue to each entry.
Ideally the ambulance entrance should be located
so not to be insight fro those coming to the
ambulatory entry.
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Signage and directions to the ED point only to the
ambulatory entrance
Ambulance drivers and emergency medical techniciansshould be made familiar with other route.
Ambulatory entrance door ways should have hands
free operations and ready accessible supply of wheel
chairs A Personnel of the hospital should be available at this
point to assess the patient into the hospital (security
personnel)
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HEALTH RECORD
In ED doctors, nurses and ancillary care givers
need to access patient record.
When p paper chart is used ther eare frequent
occasions when the of the chart is difficult todetermine and much time is wasted by care
givres looking for it
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SUGGESTIONS
The advent and utilization of the electronic
health record brings a significant opportunity to
streamline and improve patient flow.
EMR allows data to be entered any where withinthe unit especially at the patient bedside
Multiple and simultaneous access permits faster
entry and retrieval of data from within the unit
and from remote diagnostic services such as lab.
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SUPPLY PLACEMENT
For nurses if much walking is required to fetch
supplies from centralized clean supply and utility
rooms more time will elapse in the patient visit
Also when nurses spend a lot of time walking canresult increased stress and in turn decreased
effectiveness in direct patient care
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SUGGESTIONS
When supplies are decentralized and evenly
distributed throughout the department walking
distances are reduced and access time is
improved.
A Three tier supply system has proven to be
highly successful
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1st tier system- common to each bedside Alcohol wipes
Blood draw tubes etc
2nd tier system- located within just a few steps
from the patient bedside procedure trays
IV fluid
Assorted catheters
3rd system- central storages room
� Infrequently used items and back up supplies for tier1 and tier 2 are kept
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DIAGNOSIS
In ED a high percentage of patients require X-
rays
Sending patient to the radiology department has
become time consuming( transport time) queuingin the department waiting for radiologists
reading and so on..
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SUGGESTIONS
Getting diagnostic information in a timely
manner has significant impact upon patient flow
through ED
Thus it is required placing medical imagingwithin the ED
The no of radiographic devices required is
determined by the volume of patients seen in the
department
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In this case Digital radiography may result in
operational efficiency
Will decrease turnaround time for image
acquisition and result in quicker diagnosis Placing a CT scanner adjacent to trauma bays
saves critical time dealing with life threatening
situations
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DISCHARGE PROCESS
If location and assignment of beds is lowed or
beds cant be found the patients to be admitted
become boarders in ED
Boarded patients then occupies space that couldbe used to treat the next incoming patient and in
effect reduce the no of beds available to do so
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SUGGESTIONS
The proper flow of patients through ED should be
planned by formulating each step involved
effectively.
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THANK YOU