ED management : the monthly update on emergency department management
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Screening guidelines for psychiatric patients can eliminate hours of delays due to costly, time-consuming diagnostic testing. If patients don't have to undergo extensive testing, they can be treated without delay. By eliminating routine diagnostic testing, $300 per patient can be saved. If care is delayed, a patient's condition may worsen and necessitate inpatient admission.
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Significant reductions in delays and diversion hours are reported by an ED that has implemented changes as part of the GE Medical Systems Six Sigma for Healthcare process. Triage protocols for blood draws, urine, and intravenous lines are used. Nurses are paired with a technician or paramedic and work as a team. Technicians are assigned specific tasks, such as triage, electrocardiograms, or performing repeat vital signs.
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A just-released General Accounting Office report identified holding inpatients in the ED as the No. 1 reason for overcrowding. Have inpatient nurses care for admitted patients in the ED, including paperwork. Use a "bed control" office to get admitted patients discharged or transported more quickly, freeing ED beds. Consider adding an admissions nurse to handle inpatient documentation or a second ED charge nurse to track inpatients.
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You'll need strategies to improve care of patients who request pain medications frequently. Use care plans to ensure that patients with conditions such as sickle cell disease will have medications given immediately. Use written agreements to discourage drug-seeking patients. Have a system to alert ED staff to a patient's existing pain management plan.