Emergency Department Senior Assessment and Streaming Model of Care and Toolkit PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download Emergency Department Senior Assessment and Streaming Model of Care and Toolkit PDF full book. Access full book title Emergency Department Senior Assessment and Streaming Model of Care and Toolkit by . Download full books in PDF and EPUB format.
Author:
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 92
Get Book Here
Book Description
"Emergency Departments (EDs) are experiencing increasing pressure due to rising patient presentations and emergency admissions in the face of a delay in access to available inpatient beds and other resources to meet this demand. This mismatch places pressure upon the public health system to provide equitable and timely access to emergency care. The National Health Reform Agreement on Improving Public Hospital Services includes the National Emergency Access Target (NEAT) to improve emergency service accessibility. This requires ED patients to be admitted, referred for treatment of discharged within four hours. For most EDs and hospitals, meeting this targe requires significant redesign of the current process. ... Currently patients are often assessed later in the ED journey by a senior medical officer, which delays, decision-making and disposition. The ED senior assessment and streaming (ED SAS) model enables earlier senior medical input and aims to reduce ED total length of stay ... . A detailed implementation tool is supplied with this model of care ... ."--Executive summary.
Author:
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 92
Get Book Here
Book Description
"Emergency Departments (EDs) are experiencing increasing pressure due to rising patient presentations and emergency admissions in the face of a delay in access to available inpatient beds and other resources to meet this demand. This mismatch places pressure upon the public health system to provide equitable and timely access to emergency care. The National Health Reform Agreement on Improving Public Hospital Services includes the National Emergency Access Target (NEAT) to improve emergency service accessibility. This requires ED patients to be admitted, referred for treatment of discharged within four hours. For most EDs and hospitals, meeting this targe requires significant redesign of the current process. ... Currently patients are often assessed later in the ED journey by a senior medical officer, which delays, decision-making and disposition. The ED senior assessment and streaming (ED SAS) model enables earlier senior medical input and aims to reduce ED total length of stay ... . A detailed implementation tool is supplied with this model of care ... ."--Executive summary.
Author: Arshya Feizi
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
Addressing hospital emergency department (ED) overcrowding is a critical challenge for many healthcare systems worldwide. Many hospitals (including our partner hospital) have been experimenting with innovative patient flow designs to address this challenge. A promising new design is to separate patients who can be served vertically (e.g., on a regular chair as opposed to horizontally on an ED bed) and route them to a different area termed the Vertical Processing Pathway (VPP) unit. While this can potentially increase operational efficiency by removing the burden caused by a main ED bottleneck--lack of bed availability--it can degrade performance if patients that are routed to the VPP unit need to be sent back to be served in an ED bed, or if some patients that could have been served in the VPP unit end up occupying an ED bed. Successful implementation of this design, thus, significantly depends on understanding which patients should be routed to the VPP unit and when.To assist our partner hospital and other EDs, we develop a machine learning model trained on large-scale data capable of providing a personalized risk score for each arriving patient on whether or not they will eventually need an ED bed. We then feed these risk scores to an analytical model of patient flow to characterize the optimal protocol for utilizing the VPP unit. We find that the optimal protocol depends not only on the predicted risk scores but also on the machine learning model's accuracy as well as some of the main ED characteristics (e.g., patient arrival intensity and congestion level). To gain deeper insights, we make use of simulation analyses calibrated with hospital data and compare the performance of our recommended VPP-based patient streaming design with more traditional ED flow approaches such as “fast track” or “physician in triage.” Our results suggest that following the VPP design under our recommended protocol can bring several advantages to EDs, allowing them to significantly improve their operations.
Author:
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 68
Get Book Here
Book Description
"Since the publication in 2006 of the 'Emergency models of care' document for NSW hopsitals, the acceptance and implementation of emergency care models have been broadened. This has been coupled with the creation of new models to assist in emergency departments (EDs) to provide safe and timely access to emergency care. Six years later, PriceWaterhouseCoopers has been engaged to, in consultation with the NSW Ministry of Health (NSW Health), the Emergency Care Institute and the community of those involved in emergency care, revise this document. In 2011, NSW Health carried out a review to discover what current models of care (MOC) are in place in EDs and the effectiveness of these models for management demand for their services. ... Based on this review ..., this revised models of emergency care ... includes ten emergency department models of care and a number that are external to the ED and support the hospital in managing demand for emergency care. Each model has been designed to facilitate the ideal patient journey through ED."--Executive summary.
Author: Mohammed Rashidul Anwar
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
Background: Several Canadian jurisdictions have launched interventions and strategies to address the complex, multi-dimensional problem of Emergency Department (ED) crowding. Still many of the health systems struggle with long waits. Initiatives that seem to display positive results in one site/system are often unable to show similar results in another. To make sense of such patterns, I drew on a form of theory-based evaluation, Realistic Evaluation (RE). My realist analysis focused on streaming-type interventions such as Fast-track/Minor Treatment Areas, Intake/Rapid Assessment Zones, and diverse types of Short-Stay Units, which separate the whole care process of patients into different streams (based on acuity and service needs) to improve patient flow. Objective- The purpose of this thesis was to identify relevant mechanisms and contextual factors to generate "middle-range theories" for streaming-based flow interventions. Methods- This thesis used the interview data collected for a larger project, "Patient Flow and Health Systems". These interviews were conducted with 300 key stakeholders who were involved in initiatives to improve flow, in one of the ten urban/mostly-urban health regions and zones of Western Canada. I undertook a realist analysis based on participants' explanations for (perceived) success and failure. This work was grounded in the Population-Capacity-Process model, which helped to categorize factors in a meaningful way. Findings- Essential design features of streaming-type interventions that might have led to their success included identification of a designated population (population), allocation of dedicated space and resources (capacity), and establishment of rapid cycle time (process). These supported key mechanisms: patients wait only for services they need, variability among patients is reduced, standardized care is provided, lag time between care steps is prevented and provider attitude change promotes prompt discharge. Critical context factors that might have impacted the interventions were lack of outflow sites and the possibility of demand outstripping capacity. An important finding of this study was that failure of interventions was more commonly attributed to design flaws (in particular, lack of dedicated space) than to context factors. Conclusion- This study helped generate "middle-range theories" which sought to explain the outcomes of diverse interventions that share a basic program theory. In this way, it was able to provide transferable lessons for stakeholders wishing to implement similar interventions elsewhere.
Author: John M. Shiver
Publisher: Productivity Press
ISBN: 9781420083774
Category : Medical
Languages : en
Pages : 0
Get Book Here
Book Description
Across the country ambulances are turned away from emergency departments (EDs) and patients are waiting hours and sometimes days to be admitted to a hospital room. Hospitals are finding it hard to get specialist physicians to come to treat emergency patients. Our EDs demand a new way of thinking. They are not at a tipping point; they are at a breaking point. Under current loads and trends they are going to begin to break and these breakdowns will be painful and ultimately dangerous to society. Recognizing that the ideal in health care is presently beyond our immediate grasp, this book instead focuses on providing health care leaders with the tools they can employ to optimize the performance of EDs and thereby improve service to patients, employees, and communities. Written by 20 of the most progressive and successful health care reformers in the country, the approaches described can be utilized to quantify improvements, enhance predictability of workflow, and improve staff scheduling. The data derived using these techniques can serve as powerful evidence in support of change. While a common discussion among ED professionals is the perception that many patients are not really emergency patients and could be treated in another setting at another time, that argument is not germane until we as a nation elect to reform the way we chose to deliver healthcare to the underserviced. In the meantime this book provides invalauable information to help individual hospitals to retool their ED’s. It offers new approaches that think outside of the box for all stakeholders. It also provides the statistical evidence that administrators need to make their cases for changes and added resources. It will help you forecast the demand for services and give your center an approach that will allow the ED to become a source of income rather than one that continues to hemorrhage needed limited health care funding.
Author: Sherri Morrish
Publisher:
ISBN:
Category :
Languages : en
Pages :
Get Book Here
Book Description
Author: Kathleen Walsh
Publisher:
ISBN: 9781615693801
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition will ensure that ED case management staff have a solid and sustainable foundation in place. After exploring models and reviewing emergency department infrastructure, this compendium will help readers outline key partnerships, present multiple options for case finding, tackle observation status accurately, address quality and evaluation issues, and identify ways ED RN case managers and social workers coordinate care for complex cases, such as pediatric, psychiatric, homeless, and uninsured populations. In addition to many new tools, this book is also packed with more than 20 detailed spotlights and case studies discussing ED case management strategies, best practices, and experiences of ED professionals from across the country. The new edition includes: The presence of case management RNs and Social Workers in emergency departments (ED) has become a standard since the first edition of this text was published in 2007. Ever-expanding and changing regulations for EDs and hospitals have emerged, while best practices have evolved to address these challenges. This new edition discusses these changes and provides updated guidance on running a compliant, effective, and efficient case management team in the ED. It also provides insight on adapting the role of case management based on unique ED patient populations and helps ED case managers stay ahead of the curve by examining what lies ahead in their profession.
Author: Soroush Saghafian
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
Get Book Here
Book Description
Crisis level overcrowding conditions in Emergency Departments (ED's) have led hospitals to seek out new patient flow designs to improve both responsiveness and safety. One approach that has attracted attention and experimentation in the emergency medicine community is a system in which ED beds and care teams are segregated and patients are "streamed" based on predictions of whether they will be discharged or admitted to the hospital. In this paper, we use a combination of analytic and simulation models to determine whether such a streaming policy can improve ED performance, where it is most likely to be effective, and how it should be implemented for maximum performance. Our results suggest that the concept of streaming can indeed improve patient flow, but only in some situations. First, ED resources must be shared across streams rather than physically separated. This leads us to propose a new "virtual-streaming" patient flow design for ED's. Second, this type of streaming is most effective in ED's with (1) a high percentage of admitted patients, (2) longer care times for admitted patients than discharged patients, (3) a high day-to-day variation in the percentage of admitted patients, (4) long patient boarding times (e.g., caused by hospital "bed-block"), and (5) high average physician utilization. Finally, to take full advantage of streaming, physicians assigned to admit patients should prioritize upstream (new) patients, while physicians assigned to discharge patients should prioritize downstream (old) patients.
Author: Machester Triage Group
Publisher: John Wiley & Sons
ISBN: 0470757280
Category : Medical
Languages : en
Pages : 195
Get Book Here
Book Description
The Manchester Triage System (MTS) is the most widely used triagesystem in the UK, Europe and Australia, with tens of millions ofpatients being processed through hospital emergencydepartments. Emergency Triage is the core text for the MTS which utilises arisk averse system of prioritisation for patients in allunscheduled care settings, and as such it is an essential text forall emergency department staff using the MTS, in particular triagenurses themselves. The second edition has been revised throughout and takes in thechanges in practice introduced into MTS since the book was firstpublished. These include: Redesigned and expanded flow charts Additional charts for allergy and palpitations New practices - such as the possibility of revascularisation forpatients with stroke New discriminators, for example acute neurological deficit andsignificant respiratory history Redefinition of existing discriminators Also new to this edition is the incorporation of sections on theuse of the risk averse system in telephone triage, in settingswhere ‘streaming’ takes place and as an early warningscore for patients in all unscheduled care settings. The tone ofthis edition reflects the more up to date, modified approach totriage while retaining the principles of clinical prioritisation,which in the authors’ words “remains a central plank ofclinical risk management in emergency care”. Emergency Triage is an essential handbook for all cliniciansinvolved in unscheduled care settings such as emergency care, walkin centres, minor injury units, primary care out of hoursservices.
Author: Shari Welch
Publisher: ACHE Management
ISBN: 9781567934175
Category : Medical
Languages : en
Pages : 0
Get Book Here
Book Description
The Emergency Department (ED) is not only the front door to your hospital; it's where your organization is most susceptible to inefficiencies and adverse outcomes. This handbook provides the knowledge and tools you need to address or avoid the problems inherent in ED healthcare. With an emphasis on the importance of leadership, the authors explore how executives can design systems that minimize risk at the front lines. Real-world examples illustrate strategies that led to a safer, more reliable healthcare environment. Topics covered include: Elements of the ED that can contribute to waits, delays, and errors The role of the board in risk-management strategies Standardization in the ED The power of apologies in emergency medicine Popular myths and misinformation surrounding EMTALA, HIPAA, Stark, and kickbacks Management of the twelve "deadly" clinical scenarios that lead to most ED lawsuits The basics of a lawsuit, including causation, breach, negligence, and damages Survival strategies when legal action is imminent Alignment of clinicians and administrators during legal proceedings
