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Archive for the ‘ED Flow’ Category

Discharged from Intake – DINT

We are trying to track the number of pts discharged from intake– all pts that are treated and released from that area should have the dispo “discharge from INTAKE”.

Also– all pts with an “Im” or “pc” xxx complaint– they should be referred (if willing to go) to ima or peds clinic, (m-f 9 to 7p) . Their dispo should be “sent to clinic”.
Kevin Baumlin

Written by reuben

November 1st, 2010 at 9:20 pm

Posted in ED Flow

Diversion Checklist

Please use this diversion checklist to foster consistency of our diversion protocol.

tags: crowding, crowded

Written by phil

April 8th, 2009 at 7:22 pm

Wireless Phone Details

• Decrease overhead paging/ overhead noise
• Make communication more efficient
• Get out of the phone-answering business
• Trialing all clinical staff will have their own phone

MD Responsibilities:
• Don’t lose the phone
• Use the phone during all clinical shifts
• Make sure the phone is bouncing to the right “ED Zone” (1)
• Click over the patients you take over at sign-out so BAs know who is responsible (2)
• Put your call-back number on radiology requests (3)
• Residents: make sure the BAs know which phone you are carrying
• Residents: phones go in resident office if not in use by EM residents
• Residents: these phones are NOT to go to off service rotators(4)

BA Responsibilities:
• Forward calls to the attending/ resident responsible for the patient (5)
• Ask who is calling before forwarding
• Do not overhead unless the phone is not picking up

1)  Opening screen, go to “ED Zones”, select the appropriate zone-  this selects the phone your no-answer calls bounce to.  Especially important when changing from adult to peds/ east or vise-versa.

2) This is the only way BAs will know which MD is caring for a patient. You can use the sign out function in ibex to change them all over.  You do not need to click on patients with ready beds if transport is imminent.

3) Please enter your callback number on radiology requests- there is a dropdown menu available on request, or you can text.

4) Lost phones are the responsibility of the residency.

5) There is a list of all the wireless phones posted.  The residents will let you know which phone they have at the beginning of the shift.

Written by phil

April 8th, 2009 at 7:18 pm

Patient Flow as of March 30, 2009

few clarification to the revised flow:

Pt flow:

The attempt to improve pt flow taught us many lessons, but for now leadership has decided to return to pt distribution the “old way”: esi 2′s and 3′s will be distributed in rotation to all 6 primary rn’s evenly.  We will no longer be “cohorting” admitted pts.

Resus Pts will rotate to north and south teams for care.  (if no resus resident is scheduled)
Pts coming out of the resus room will be distributed to the appropriate zone.

When a resus resident is working:   all resus pts will go to the resus resident.  pts coming from the resus room, will be evenly distributed to the north and south zone geography and rn staff.

Physician staffing:

If staffing permits, an EM resident will be assigned primarily to care for  pts in the resus room.   Post stabilization resus pts will be distributed to both the north and south zone– they will continue to be monitored by the resus resident and resus attending.

It is possible that the south zone may be staffed by 2 interns and an attending.  This staffing poses risk, especially if esi2 pts are assigned to the south zone.  Attending physicians are encouraged to adjust staffing in the ED on a shift by shift basis, and they are encouraged to discuss staffing with the charge nurse to ensure the safety of our pts at all times.

Kevin M Baumlin, MD

Written by reuben

March 31st, 2009 at 4:36 am

Posted in ED Flow,Residents