8/26/08- Crawford Long Visit

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During the Crawford Long visit, I was struck by many of the problems associated with this ED. The first of these being an issue of site circulation. Specifically, it was pointed out that many of the patients enter as a pedestrian from the street and it is not obvious where the ED entrance is located. For those not on foot, parking is also an problem as there is an insufficient number of parking spaces. Inside the ED, the greatest two issues that I observed were overcrowding of space and noise levels. The nurse told us that a large pane of plexi that had been installed at the nurse station was put in as a noise buffer. She mentioned that most of the staff believes this hasn't helped and may even make the noise reverberation worse. The problem of accoustics seems to be very important because the high noise level added greatly to the feeling of chaos. It would also be an issue for patient privacy and in the process of communication between the staff and patient. This would especially be true of the patients in the temporary bed slots in the halls of the ER. Overall, this tour helped me to get a better general understanding of the ED process and problems associated. I think that it might be helpful for some of us to observe the actual process itself (instead of a guided tour). This may be beneficial in helping us recognize the more specific issues that are associated with the department. I asked the nurse a few times what some of the problems were that she had to deal with, and some of the answers were broad. Ex, we are always stressed for time, there isn't enough space... perhaps a closer observation would help give us a deeper insight into the intricacies and specifics of some of the problems.