EMERGENCY ROOM OF THE FUTURE

1. EMERGENCY ROOM OF THE FUTURE Group 3 Chung-Lun Kua, Brandon Thompson, Sue Bhat • Hallway Beds • Ambulance Diversion • Records Management September 23, 2008

2. 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

3. 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

4. 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

5. 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

6. Ambulance Diversion HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

7. 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

8. 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

9. 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