Safety

Manage services, manage ED flow

Emergency Management Alert, June 6, 2006

Manage services, manage ED flow

From the authors of the abovementioned Solving Emergency Department Overcrowding is this advice on how to mitigate use of ancillary services.

"The ordering of unnecessary or excessive tests delays patient throughput, artificially raises triage levels when using the Emergency Severity Index or similar triage scales, and is frowned upon by third-party payors," say Bud Pate and Derenda Pete. Mentioning that they're concerned mostly with the first consideration, the authors recommend two approaches to dealing with the problem:

  • Develop protocols by collaborating with the laboratory and imaging departments to help guide physician practice.
  • Develop protocols for nursing so physicians can make the decision to test earlier rather than later.

      Chest pain protocols, they say, should always be in place. Protocols for other complaints, such as diabetic patients, abdominal patients, intoxicated patients, etc., can help physicians and staff get the right test the first time rather than having to wait for follow-up testing.

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