emergency dept

8/7/2019 Emergency Dept

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IN AND OUT OF THE

EMERGENCYROOM

Streamlined design of patient flow

Venisha Naina D·Souza



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.



FOUR MAIN AREAS TO BE COVERED

Arrival

Health record

Supply placement

Diagnosis

Discharge process



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



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.



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)



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



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.



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



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



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



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..



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



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



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



SUGGESTIONS

The proper flow of patients through ED should be

planned by formulating each step involved

effectively.



THANK YOU

emergency dept

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