ED management : the monthly update on emergency department management
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A care management unit can dramatically increase bed availability. Consulting with internal medicine and the financial department can help identify key sources of bottlenecks. Creative use of existing beds can make space available for a new unit. Case managers can arrange primary care physician follow-up and track ongoing patient compliance after discharge.
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You can use rapid-cycle testing to try out new approaches to overcrowding much more frequently than with more traditional process improvement strategies. Improving bed turnaround notification can yield dramatic improvements. Telling staff they have to try a new process only for three days makes it easier to gain buy-in. Look for old policies that are no longer needed, yet continue to keep your staff bogged down.
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Under a new accreditation standard, EDs and all departments must be prepared to handle an influx, or the risk of an influx, of infectious patients. Collaborate with your infection control committee, disaster management committee, local board of health, and other providers to develop protocols and policies. Hold disaster drills in which you must handle infectious patients. ED staff, particularly the triage nurses, need training in early recognition of presenting symptoms of infectious diseases.