SLIDE 1
Emergency Department Overview
Tatiana Acosta Thayse Darzi Esperanza Muino
SLIDE 2 General Definition
Emergency Department (ED) is a section of an health institution that is staffed and equipped to provide rapid and varied emergency care, especially for those who are stricken with sudden and acute illness or who are the victims
- f severe trauma. The emergency department
may use a triage system of screening and classifying patients to determine priority needs for the most efficient use of available personnel and equipment.
SLIDE 3 It’s the process by which patients are classified according to the type and urgency of their conditions to get the:
- Right patient to the
- Right place at
- Right time with the
- Right care provider
Triage System
- Resuscitation
- Emergent
- urgent
- less urgent
- Non urgent
Triage Levels
SLIDE 4
General Related Facilities/Services
Mild fever, cold or flu Sprains or strains Minor allergic reaction Ear or sinus pain Nausea, vomiting or diarrhea Rashes Sore throat Minor cuts Painful urination Heat stroke and dehydration Urinary infections Minor burns Cough Dizziness Headache Pink eye Mild stomach pain Heart attack Trauma Cardiac arrest Chest pains Numbness in face, arm or leg Difficulty speaking Severe shortness of breath Symptoms of a stroke Deep cuts Infants under 12 weeks old with a fever Head or eye injuries Severely broken bones or dislocated joints Severe flu or cold symptoms Severe abdominal pain Serious burns Blurriness of vision Vaginal bleeding with pregnancy Severe asthma attack poisoning
SLIDE 5
Common Emergency Department Patient Flow Chart
SLIDE 6 General Characteristics & Equipment
An ED requires different equipment and different approaches than most other hospital divisions. Patients frequently arrive with unstable conditions, and so must be treated quickly. They may be unconscious, and information such as their medical history, allergies, and blood type may be
- unavailable. ED staff are trained to work quickly and effectively even with minimal information.
Because time is such an essential factor in emergency treatment, EDs typically have:
- Their own diagnostic equipment to avoid waiting for equipment
installed elsewhere in the hospital.
- Nearly all have radiographic examination rooms staffed by
dedicated radiographers.
- Many now have full radiology facilities including CT scanners and
ultrasonography equipment.
- Laboratory services may be handled on a priority basis by the
hospital lab, or the ED may have its own "STAT Lab" for basic labs (blood counts, blood typing, toxicology screens, etc.) that must be returned very rapidly.
SLIDE 7
Care Providers Physicians & Nurses Background & Education
Emergency medicine physicians make immediate treatment decisions about a patient of any age or gender who is experiencing a medical emergency, they follow stabilization, and admits the patient to the hospital or discharges the patient from the emergency room with a referral to an appropriate physician for follow up. They do not work out of medical offices, see patients by appointment, or follow patients with chronic conditions, they usually work on a determined schedule, allowing them more control over their personal lives. Emergency medicine physicians must have a graduation from an accredited medical school and obtain license to practice as a medical doctor, after they perform a residency in emergency medicine. These are either 3 year or 4 year residencies, and the physician must pass both written and oral exams to be board certified. A re-certification is required every 10 years through the Maintenance of Certification (MOC) program. Subspecialty certification varies depending on the subspecialty chosen, it can be a year (such as sports medicine) or more. Emergency medicine physicians can be certified as: Emergency Medical Services Hospice and Palliative Medicine Internal Medicine–Critical Care Medicine Medical Toxicology Sports Medicine Undersea and Hyperbaric Medicine
SLIDE 8
Emergency Nurses need to continually prioritize patient care and provide ongoing assessment and treatment of a diverse patient population with varying degrees of illness in an uncontrolled, unpredictable environment with an indefinite workload (Emergency Nurses Association (USA), 1988; Curry, 1994). Nurses diploma can be a 3 year or a 4 year program degree, and to become an emergency nurse takes an extra time-period and certificate. Emergency Nurses specialization varies according the facilities and services.
Care Providers Physicians & Nurses Background & Education
SLIDE 9 General Design Guidelines
- Heightened emphasis on improving patient outcomes
- Use of Lean concepts to optimize operational efficiencies.
- Super-flexibility for quick expansion.
- integration of technology.
- Accessible to the community.
- preparation for catastrophic incidents.
Emergency Department Staff requirements:
- Emergency medicine requires relatively high levels of staffing
- multi-disciplinary team, working on a 24/7 basis.
- safe, ergonomically efficient work environment
- The ED must provide a suitable environment.
- Ambulance Staff who may attend with patients.
SLIDE 10
Case study
20900 Biscayne Blvd | Aventura, FL 33180
SLIDE 11
Aventura, FL Population/Demographics
RELIGION OVERVIEW 39.76% of the people in Aventura, Florida are religious, meaning they affiliate with a religion. 21.99% are Catholic 0.60% are LDS 5.66% are another Christian faith 1.13% in Aventura, Florida are Jewish 0.18% are an eastern faith 0.92% affiliates with Islam.
SLIDE 12
Emergency Department Patient Flow Chart
SLIDE 13 Related Facilities/Services
Common Medical Emergencies
- fever of 102 degrees or higher in children or 103 degrees
for adults.
- Broken bones or serious sprains that affect mobility
- burns that is larger than the size of your hand
- Large or deep wounds, that bleed heavily
- Severe allergies or asthma attack
- Heart attack or stroke symptoms, including chest pain,
dizziness, fainting, slurred speech, confusion, and partial paralysis or muscle weakness.
- Diagnostic services, such as a physical exam, blood
tests, and diagnostic imaging.
- Illnesses may be treated with medication such as
intravenous fluids to prevent dehydration.
- In cases of severe illness, onsite monitoring may be
required.
- Wound care and trauma
- An orthopedics specialist may treat broken bones
- surgery is needed, it may be scheduled immediately
SLIDE 14 Design Guidelines
Wayfinding
- Signage system, terminology, and lighting may afford clarity of information/directions/location.
- Reception areas are major elements in this project.
Privacy and Personal Territory
- Visual and acoustic privacy and control are issues that will need to be considered in relation to
the patient care room environment.
- Room configuration, adjacencies, materials and finishes are important factors.
- Areas associated with financial matters will require privacy as well.
Safety & Security
- Surveillance and control issues are important Psychologically.
- Line of sight and acoustic issues are always a concern.
- Complete view of reception areas from the receptionist is important.
- Storage of personnel items of the employees as well as the patients will
need to be considered.
SLIDE 15 Design Guidelines Cont.
Comfort
- Activity requirements
- Flexibility in : light, views & furnishing
Materials/Finishes
- Color, textures, static electricity, durability, maintenance and psychological considerations.
Theory of integration
- Uses of theories related to patient care
Art Program
- Development of an art program that would be appropriated for this care environment
- The art program for healthcare environments is especially important as it may affect user’s
productivity and psychological comfort.
SLIDE 16 Questions for interview with Architects and the Hospital
For the Staff
- What are the major problems of working in an emergency department?
- How you classify the emergencies?
- How do you think we can reduce patient’s waiting time?
- How is the process of maintenance/ cleaning?
- What is the maximum capacity of people at the ED?
- Do you have Privacy issues? How do you address them?
For the Architect
- What state regulations have made it difficult for the design of the facility?
- How do you define territories of both the patient and the staff without blocking or creating barriers?
- Explain storage requirements
- Does this facility incorporate sustainable features and practices?
- What was the concept or inspiration for the interior design of this facility?
- In general do you consider the furniture used in healthcare facilities appropriate for patients,
doctors and staff?
SLIDE 17 http://aventurahospital.com/service/emergency-care
References
http://www.clrsearch.com/Aventura-Demographics/FL/Population-by-Race- and-Ethnicity
- Davidson, T. (2013). Emergency Medicine. In Gale (Ed.), The Gale encyclopedia of nursing and Allied
- Health. Farmington, MI: Gale. Retrieved from
http://ezproxy.fiu.edu/login?url=http://search.credoreference.com/content/entry/galegnaah/emerge ncy_medicine/0.
- Mazzi, A. (2015). New strategies in ED design. Health Facilities Management. Retrieved from
http://www.hfmmagazine.com/articles/1451-new-strategies-in-ed-design
- Nursing. (2010). In H. Marcovitch (Ed.), Black's medical dictionary, 42nd edition. London, United
Kingdom: A&C Black. Retrieved from http://ezproxy.fiu.edu/login?url=http://search.credoreference.com/content/entry/blackmed/nursing
- Patient Safety and Quality of Emergency. https://www.acep.org/News-Media-top-banner/Patient-
Safety-and-Quality-of-Emergency-Care/
- Aventura Hospital and Medical Center
- Aventura Demographics & Population
