It is 2018 and the we have been discussing ED boarding for well over 20 years. There are numerous resources that have suggested methods to combat the problem. What once was a problem easily fixed by moving people out of the ED and parking them on nursing units, has become an increasingly complex beast. If your hospital is struggling, like
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The performance of your environmental services department is a critical step in your hospital’s patient flow. The ability of patients to enter your hospital as direct admissions or through the emergency department relies heavily on bed availability. Many institutions focus on clinical decision making and patient care when examining patient flow. However, focusing on the performance of your environmental services
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ED flow is challenging. For all of those who struggle with defining various aspects of patient care in the emergency department, this is a mind map you may find helpful. (PDF) ED Flow Mind Map
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Unless you work in a small hospital with critically low volume and a mostly empty ED, you are combatting crowding. ED crowding is at an all time high and the number of emergency departments in the US is shrinking as the number of ED visits increases. Though we once may have been able to accommodate lengthy evaluations and extensive imaging
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So you have decided to embark on a provider in triage and you are building your process for the work area. What form will you choose? In this installment of the patient flow series, we will discuss some of the options that have been successful: 1) Physician triage: This process supplants the triage nurse with a physician. It is commonly
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Much has been published regarding the use of scribes in the past few years. The position was born out of a need for reducing data entry time by physicians, while simultaneously increasing efficiency of the physician and allowing more time face to face with patients. Although they were once primarily utilized in emergency departments, scribes today are found in all
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As many hospitals battle the national physician shortage, emergency physicians are increasingly being asked to write inpatient orders. These are abbreviated orders meant to facilitate the patient’s transition to the inpatient unit and are typically named “holding”, “bridge”, or “interim” orders. When faced with the question of developing this process, a few things should be addressed. 1) Purpose It is
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Many people have written about the segmentation of patient populations in the emergency department, based on acuity. Let’s take a look at it a little more closely in today’s installment of the patient flow series. Patient segmentation is the process of dividing patients (based on acuity in our case) and processing them through an emergency department visit differently based on the category they fall into.
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This is a question many emergency departments struggle with due to the demands of increasing patient volume and increasing wait times. Many departments have successfully deployed physicians or advanced practice providers in an “up front” process that has patients seeing a provider first. However, this practice is fraught with problems if it is applied in the wrong setting and, as
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Within the past 10 years, it is very likely that you have come across the “silo” metaphor. It is now commonly used in US healthcare to describe the isolation of a resource or information from the rest of the system. I have seen the metaphor used to describe patient flow, healthcare data, and financial structures within a hospital. In all
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