Emergency Department Annual Census ~60,000 Daily Census ~ 160 - - PowerPoint PPT Presentation

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Oct 27, 2022 388 likes •602 views

Emergency Department Annual Census ~60,000 Daily Census ~ 160 (Range 130-220) Admission Rate ~23% Emergency Department is comprised of the Triage/Medical Screening area, and four treatment areas, or zones 27 treatment

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Emergency Department

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Annual Census ~60,000 Daily Census ~ 160 (Range 130-220) Admission Rate ~23% Emergency Department is comprised of the

Triage/Medical Screening area, and four treatment areas, or zones

27 treatment rooms/bays and 8 treatment stations

in designated hallway areas

8 Clinical Decision Unit Beds Full Staffing

17 RN’s + Charge Nurse for ED 2 RN in Clinical Decision Unit 7 Ancillary Staff (MEA/Clerk)

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Up to 4 work stations

Two private offices Two additional spaces as needed

2 RN’s Greeter—RN or ancillary staff Recent Flow/PI Projects have included adding

a provider at triage during peak hours to see appropriate patients from the lobby and discharge home

RN staffing can be flexed up during provider at

triage times and also during peak volumes

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8 treatment rooms and 4 gurneys in designated

hallway areas

4 resuscitation rooms 4 exam rooms Patient census fluctuates throughout the day along

with acuity

Ambulance Diversion when Zone 1 census reaches 12 Highest acuity patients Trauma Activations initial evaluation Medical Resuscitation Violent or Agitated patients 6 Assigned Nurses Charge Nurse can flex RN assignments and provide additional

Zone 1 support during periods of high acuity and/or census

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Trauma Resuscitation Room

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Circulator Nurse

Makes patient assignments Coordinates breaks and break coverage Assigns RN’s for each trauma case Works closely with Charge Nurse and Attendings to

coordinate Zone 1 flow

Can take low acuity patient assignment

Acuity Nurse

Typically, does not takes a patient assignment Performs bed side care, tasks, transports, and monitoring

f patients

Primary Nurse

Takes patient assignments up to 4 patients

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4 open treatment bays Staffing

1 Primary RN 1 Float/Break RN (floats between Zone 2 & 3) MEA (floats between Zone 2 & 3)

Medical complaints, minor injuries, admitted

patients, and evaluated & stable trauma patients

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5 open treatment bays and 1 private exam

room

Staffing

2 RN’s 1 MEA (floats between Zone 2 & 3)

Medical complaints, minor injuries, admitted

patients, and evaluated & stable trauma patients

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9 exam rooms and 4 gurneys/chairs in

designated hallway areas.

2 negative pressure

Staffing

3-4 RN’s 1 MEA 1 NP

Medical complaints, minor injuries, admitted

patients, and pediatrics

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Located on 4C 8 Beds Staffing

2 RN’s 1 MEA 1 NP

Defined inclusion/exclusion criteria Observation patients and admitted patients

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During periods of:

increased acuity

-or--

increased census

-or--

less than optimal staffing

...part of the CN role is collaboration with ED NM/ND/AOD in order to re-deploy staffing resources and to best fit the requirements of the department

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= Redeployed RN’s

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= Redeployed RN’s

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Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2012 15% 20% 19% 17% 19% 20% 17% 22% 22% 26% 29% 39% 2013 34% 38% 39% 37% 36% 36% 43% 36% 42% 37% 34% 34% 2014 49% 39% 36% 36% 35% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

JCC Report Diversion 2012—2013—2014