1. An Assessment of the Emergency Department 2/15/99 Sara Dawson Brian Decker Samira Madhany Project Advisor: Dr. Doris Quinn Department of Quality Assurance

2. Is the VUMC Emergency Department Efficient? Our Goal: To provide a database and a simple, convenient interface for data collection giving information of the processes in the VUMC Emergency Department. From this data we hope to determine any trends in patient flow and identify problematic areas.

3. What have we done? Met with Dr. Quinn, Jane Crofut R.N. (admin.), Jim Bihun (ED Financial Manager), Jesse Loflin (ED Computer Networks) on 1/29/99. –Jim Bihun’s goal - time for any patient to see physician after in room. –Jesse Loflin is very interested in helping develop a database that will share information on a hospital wide scale. –Need to define the wait times to be collected and exactly when, in the process, to be collected.

4. …What Have We Done? Have some preliminary designs for database tables. Have approved flow chart of patient flow process in the ED. Spoke with Dr. James Crowe about a machine used as a dedicated server with Cold Fusion software installed.

5. Patient Flow for VUMC ED

6. Proposed Database Designs Demographics - Pt.#, Name, Age, Sex, Private/Family M.D. Visit Description - Pt.#, Date, Reg. Complaint, Diagnosis, Accuity, Attending M.D., Consulting Services Wait 1 - Pt.#, Date, Reg. Time, Triage Time Wait 2 - Pt.#, Date, Triage Time, Room Time Wait 3 - Pt.#, Date, Room Time, Res. M.D. Time Wait 4 - Pt.#, Date, Res. M.D.Time, Att. M.D. Time Wait 5 - Pt.#, Date, Att. M.D. Time, Interface Time, Services Wait 6 - Pt.#, Date, Interface Time, Treatment Time, Treatments Wait 7 - Pt.#, Date, Treatment Time, Disposition Time, Admitted/Discharged Demographics –Pt.#, Name, Age, Sex, Private/Family M.D. Visit Description – Pt.#, Date, Reg. Complaint, Diagnosis, Accuity, Attending M.D., Consulting Services Wait Times –Pt.#- Att. M.D. Time –Date - Interface Time –Reg. - TimeServices –Triage Time - Treatment Time –Room Time- Treatments –Res. M.D. - Time Disposition Time –Admitted/Discharged or Design #1Design #2

7. What are we working on right now? Continuing with the database designs. Meeting with Dr. Quinn and Jane Crofut - 2/18/99 –To discuss the definition of wait times and data collection points. Devise a front-end in Cold Fusion to allow simple, but secure access to the database via the World Wide Web.

8. What do we hope to accomplish in the near future? Once again, plan on visiting the ED to become familiar with processes. Determine if Cold Fusion is a secure enough application for electronic databases on patient information. Do some outside research on information security for patient information.

9. For further information... Project Homepage - http://vubme.vuse.vanderbilt.edu/specialed/ http://vubme.vuse.vanderbilt.edu/specialed/ Similar applications - –http://www.hass.com.au/M_ED.htmlhttp://www.hass.com.au/M_ED.html –http://www.iba.com.au/http://www.iba.com.au/ –http://www.merginet.com/tgp/9803/executone.h tmhttp://www.merginet.com/tgp/9803/executone.h tm