ED management : the monthly update on emergency department management
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Ensuring a smooth transition when your hospital adds a palliative care program can help improve throughput in your department while enhancing patient care and flow throughout for the facility. Here are some key steps for you to take: * Develop and/or obtain from the palliative care department a set of triage triggers for palliative care admission and palliative care consults. * Communicate the triggers to your staff. Post the triggers prominently, and publicly recognize physicians who are using them on a regular basis. * Make sure ancillary department staff such as social workers and chaplains are available for lengthy consultations with family members.
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Having a portable ultrasound available to your ED will enable you to perform scans during the nighttime hours, instead of having patients wait for several hours until the radiology department opens. Additional time can be saved by having a technologist read the scans, which frees your ED physicians for other duties. Having ED docs contact the technologist directly, rather than going through a resident, also saves valuable time. Arriving at a diagnosis more quickly provides a boost to patient safety.
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Empowering frontline staff to share new ideas for improving processes and to participate in departmental decision making can lead not only to valuable new ideas, but will boost staff morale and lead to consistently high patient satisfaction levels. Have nurses sit in on all interviews for potential new employees, as well as on policy and procedures committee. Satisfied nurses with positive attitudes lead to a greater focus on the patient. When you receive complaints about a specific nurse, ask the nurse what could/should have been done differently.
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A report from the Centers for Disease Control and Prevention can be used to benchmark your department against national averages and offer explanations for what management might call "poor performance." For example: One-third of EDs cite staffing shortages or overcrowding as caused of diversion. Does your ED suffer from one--or both? What are your nursing vacancies? Half of EDs in metropolitan areas had more than 5% of their nursing positions vacant. Since 8% of the hospitals nationwide are not allowed to go on diversion, ED crowding is not just a diversion issue.