Emergency
Department
Marking one of emergency medicine's most
pressing issues is the ability of facilities and emergency department
staffs to handle the increasing number of patients presenting
for care. It has become a reality that failing to speed up patient
care may actually jeopardize quality care.
Every emergency department has examples
of the variances in productivity between different nursing and
physician staffs. Everyone also knows that they would rather work
in or be a patient in a productive, efficient department where
the patients are happy and the staff is satisfied with their work.
Following are a series of simple steps
for physicians that will help manage their time and the workflow
in a busy emergency department.
1) Stay focused on your work.
Concentrate on patients. Avoid activities prior to your shift
that can distract or hamper your mental or physical ability to
cope with a busy department. Also, don't conduct personal business
during your shift.
2) Anticipate phone calls to consultants
or other staff. When the plan for a particular patient is clear-cut,
don't wait for the complete work-up before making the necessary
calls. Tell consultants early about patients likely to need
their expertise so they also can plan their time.
3) If working alone, don't necessarily
take charts in order. Manage your work and the staff's to facilitate
movement of the easy cases through the emergency department.
Keep the easy ones moving while you deal with the complex cases.
4) When ordering tests, try to order
all that are needed initially. Avoid doing sequential work-ups
that require additional time and attention of the entire staff.
5) Anticipate your needs and the patient's
needs. For instance, start the admission process as soon as
you realize the patient has to be admitted. Anticipate the need
for an ICU bed, med-surg bed, consultation, etc. By making the
arrangements as soon as possible, the patient flow dramatically
speeds up.
6) Review the cases you are currently
processing in order to keep tests and consults on track, doing
whatever is within your control to maintain the flow in the
emergency department. Take ownership of the overall process
and rapidly recognize and correct situations that bottleneck
the department.
7) Let patients know that you care, no
matter how busy you become. Always introduce yourself, apologize
for the wait, make eye contact, sit down as much as possible
and let the patient talk uninterrupted for at least 30 to 60
seconds. Remember, the busier the department the more anxious
everyone becomes.
Patients, family members and staff look
to the physician to provide a calm, efficient demeanor and productive
environment. By utilizing these techniques, you may improve the
experience for everyone involved and amaze yourself at how well
you can manage a busy department.
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