ED management : the monthly update on emergency department management
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The more care you can provide while patients are still in triage, the more time you will save. Quick registration process enables X-rays and lab work to be ordered while patient is in the waiting room. Electronic medical record enables doctors to enter orders on any computer in the department. Persistence with staff will let them know you are truly committed to changing triage processes.
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The new era of Joint Commission on Accreditation of Healthcare Organizations surveys requires an extra measure of preparation, as well as a refresher course on how to respond if surveyors find violations in your ED. Participate in periodic performance reviews, and make an effort to get on your hospital's Joint Commission committee. ⋯ Be honest, and solicit their involvement in finding solutions. Overcrowding, medication management, and privacy will be the Joint Commission's major areas or emphasis during surveys.
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Make sure your staff know whom to contact and when concerning organ donation. The right action at the right time can avoid potential liability and ensure optimal communications with family members at a time of heightened emotional sensitivity. ⋯ Develop ongoing relationships with organ procurement agencies, and make sure your staff know the appropriate contact at each agency. Having an individual other than the caregiver approach the family will reduce risk of legal exposure.
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Focus on practitioners' needs to develop a diversion plan that makes sense and will be effective. Directing patients to the right facility will eliminate duplication of efforts on histories and tests. Limit the amount of time a hospital's ED can be on diversion before it must again accept ambulance patients. Tracking the performance of EDs creates pressure to adhere to requirements of program.
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Proactive communication with your patient and family members can clarify the decision-making process. Even if patient has a do-not-resuscitate (DNR) order, reconfirm patient's wishes when possible. Let family know if you do not believe a treatment will be efficacious. Initiate discussions with patients whom you think should consider having a DNR.