1. EMERGENCY ROOM OF THE FUTURE Group 3 Chung-Lun Kua, Brandon Thompson, Sue Bhat September 23, 2008  Hallway Beds  Ambulance Diversion  Records Management

2. Hallway Beds Observations  4 patients in the hallway  12 total hallway bed stations  Typically reserved for low acuity patients  Beds filled by order of arrival  Lack of electrical outlets  Medical carts not linked to nursing station  Patients have to be moved out of rooms into hallway sometimes HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

3. Hallway Beds Issues  Patient privacy  Patient liaison receives higher complaints from hallway beds in front of nursing station  Patients must be moved for sensitive screening  Nurse privacy  Noise level in the hallway  Family crowds hallway – nowhere to sit HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

4. Ambulance Diversion Observations  Emory uses eRESCUE  Requests help from Hospital  Attempt to reduce diversion  Criteria is hospital specific  EMS can still deliver patients  EMS – patient chooses hospital regardless of diversion HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

5. Ambulance Diversion  eRESCUE Criteria (need 2 or more triggers)  All beds full & > 12-15 patients in waiting room  Holding 2 or more patients for ICU  Holding > 4-6 patients for bed assignment  Level 2 acuity patients in waiting room  Total ED volume > 45  Diversion Criteria  eRESCUE insufficient to decompress ED saturation status HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

6. HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

7. Records Management Observations  Emory uses Electronic Record System  Able to access electronic medical records  Patient status available to all nurses  Can track lab status  Data entered by:  Admin, Triage, ER nurse, MD  EMS provides a paper registration form  Meds can be ordered electronically HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

8. Records Management Issues  Electronic Record System  Unable to pull electronic records from other hospitals  EMS registration must be entered manually  EMS provides a paper registration form  Patients’ registration papers must be entered manually (why not let patients enter their own data into the computer?) HS 8803: Emergency Room of the Future Group 3: Brandon, Chung, Sue

9. Observation References Emory Crawford Long Emergency Department  Valorie Sweigart, RN, ER Nurse Director  Donna McCloud, RN, ER Charge Nurse  Candice Dickson, ER Clerk  Marjorie Bolton, ER Patient Liaison