Healthcare of the Future: EMT Problem Statements

1. Healthcare of the Future: EMT Problem Statements Jenny Liu, ECE Jelece Morris, HSI David Woods, Arch Erxi Liu, Arch Fall 2012

2. Problem Statement: Ambulances arriving at the Emergency Department at Grady have been observed to take an average of 18 minutes to transfer a patient to the ED. A shorter time of patient transfer into the hospital’s triage queue allows medics to circulate and respond to other calls. Analysis of process flow can be critical to improving opportunity cost of EMS, triage and the hospital staff. Background Typical ambulances are staffed with 2 medics (1 EMT driver, 1 paramedic with the patient) At time of unloading, both medics accompany the patient into the ambulance bay of ED and stay until the triage nurse accepts patient into triage queue Finance Average cost of ambulance transport for providers: ~$415 Ambulance transports accounted for 31 percent of the providers’ revenues (Medicare 2004) Problem 1: Process Flow

3. Solution Space consideration Placement of stretchers in the ambulance bay Redesign of overall ambulance bay Triage tracks Fast track Employed at Midtown Additional resource: Improving patient flow in the emergency department (Healthcare Financial Management: Journal of the Healthcare Financial Management Association, 2008) Communication Quicker transfer of medical information Interdisciplinary problem HSI: process flow, logistics ECE: devices, technology aids in transfer/communication ARCH: space restrictions/efficiency Timetable A recommendation/model can be made by December Scalable generalize flow process for multiple hospitals Within scope of project focusing on time that the patient arrives at the hospital via ambulance and is entered into the triage queue Out of scope Outside of the hospital High level injury that bypasses triage Problem 1: Process Flow

4. Problem Statement: In the ambulatory services area of Grady’s Emergency Department, medics have been observed verbally exchanging information to the triage nurses. This method of communicating patient information may lead to increased opportunities for error, compromising HIPAA, and requires more time than other means of information exchange. There is an opportunity to further investigate ways to keep patient information protected and reduce the risk of violating HIPAA. Background Hospitals are required to comply with Privacy and Security Rules The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral. What Information Is Protected Information your doctors, nurses, and other health care providers put in your medical record Conversations your doctor has about your care or treatment with nurses and others Problem 2: Information Privacy

5. Solution Bump/Bluetooth Near field communication Exchange information without wires, security issues, or error during transfer Directional sound Sound domes to communicate under Interdisciplinary problem Health Systems: Understanding of HIPAA violations, communication processes Electrical Engineer: Coding devices for information exchange Architect: Environment structure in which information is being communicated Timetable A recommendation or solution can be arrived at by the end of the semester Scalable multiple Emergency Departments Scope Verbal information communicated from paramedics to triage nurses Out of the scope Things not occurring during that time frame Problem 2: Information Privacy