26 Aug: Tuesday - Crawford Long ED tour

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Crawford Long ED visit

The tour of Crawford Long’s Emergency Department was very informative. ER Nurse, Terra Jackson led my tour group and described the process in which patients were admitted, triaged, and cared for during a typical ER visit. The following bullets list my observations and answers to questions.

1. I first noticed a patient in a wheelchair outside the ER wait 10 minutes for a car to take her home. The patient seemed to have been discharged. There were no nurses to help her in the car and the curbside pickup was not conducive to patients in wheelchairs.

2. There are 5 family rooms where patients can wait. The family rooms were clean and quiet. However, the family rooms were isolated from the ER and no one was using them.

3. EMS communicates with the ER via radio or phone. They have the ability to fax an EKG while driving to the ER. There were three stalls for Ambulances at the ED.

4. The waiting area was large and clean. There was a lack of information pamphlets or educational brochures that family members could read to find out about their families illness.

5. Crawford Long uses a 1-5 scale for triage. There are 3 triage rooms. All of the rooms were different. Only one triage room had a bed. The goal for the ER is “Door to decision in 10 minutes.”

6. There was a computer in every room where nurses could update any patients’ information. The nurses at the ER desk had two flat screen TVs that allowed them to see the ER patients’ status.

7. There was equipment stored in the hallway right next to overflowing soiled linen bags. There were 5 or 6 patients in the hallway in the acute care area when several rooms were empty. There were no patients in the express care area but that was briefed as the overflow area for the acute care area. The patients in the hallway were placed right in front of the ambulance entrance.

8. The nurses have easy access to prescription medicine using a machine (Pixus) that verifies the nurses by finger print.

9. Nurse Jackson stated that patients sometimes have to wait due to a lack of beds in the hospital. If a patient in the ER has not been admitted to the hospital then they remain in the ER until there is space for them.

10. The CDU rooms allow for patients to remain in the hospital for extended hours without being admitted.

Questions

1. What is the most inefficient system or process in the ER? A. Acute care, need more physicians.

2. What are the patients’ biggest complaints? A. The wait times.

3. What are the criteria for opening up beds or moving patients? A. “Just kind of pick and choose who is more stable.” Nurse Jackson