Communication, teamwork keys to system’s success
Communication, teamwork keys to system’s success
For an ED to succeed with a system such as the rapid medical evaluation (RME) process adapted by many ED clients of California Emergency Physicians/ MedAmerica (CEP/MedAmerica), a Laguna Hills, CA-based emergency physician management company, the manager must overcome several challenges, says Diana S. Contino, RN, MBA, a consultant for CEP.
For the patients who are stable and continue to wait for testing, using the waiting room requires significant communication and collaboration between the physicians, nurses, and patients, she says. "Documentation is also key, as many worry that the patient will leave prior to their tests being completed — and if registration is also not complete, how will we reach the patients?" she asks. "Again, it comes down to teamwork and the identification of processes."
Many sites identify a patient flow that requires full registration immediately after the patient evaluation and prior to placing the patient in the waiting room, she says. "Another strategy is to ask the patient, If we are unable to locate you immediately, what number can we call you at, as we want you to return for your test results?’" says Contino. "Also, keeping patients informed of the potential delays and what they are waiting for requires that there be a team approach to the front entrance of the ED."
Many sites with volumes of 30,000 and greater have given up on having a single nurse at the window but have opted for a registrar to do "quick-reg," a tech to assist with vital signs and moving patients, a nurse to assess the emergent and urgent patients, and a provider to quickly see and often discharge the minor care patients, Contino says. This team is able to keep those stable patients who have been removed from the ED rooms and are in the waiting area informed, and then discharge them when all their tests have come back, she explains.
The most important factor in moving stable patients to the waiting area is the communication between what the physician is thinking — medical decision making and pending tests — and what the plan of care is if the tests come back normal or abnormal, Contino says. "It is also highly beneficial if the clinicians can agree on the patients’ stability and ability to be comfortable and safe in the waiting room," she adds.
For an ED to succeed with a system such as the rapid medical evaluation (RME) process adapted by many ED clients of California Emergency Physicians/ MedAmerica (CEP/MedAmerica), a Laguna Hills, CA-based emergency physician management company, the manager must overcome several challenges, says Diana S. Contino, RN, MBA, a consultant for CEP.Subscribe Now for Access
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