Emergency Department Models of Care 2012 - NSW Health

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Monitoring andevaluation■■■■■■Time from start to end of triageThe appropriateness of triage category allocationNumber of occasions when flexible plans were activated to support peak periods ofdemand; analysis to understand the underlying causes (for example, growth in EDpresentations, downstream system delays)Time to treatment by a clinician, by triage category.Patient complaints and adverse events.Staff feedbackPAGE 14 NSW HEALTH Models of Emergency Care
3.2 Clinical Initiatives NurseResuscitation/traumaQuick triage & RegistrationTriageRegistrationClinical Initiatives NurseSub Acute2 hoursFast trackWhat is the model?The Clinical Initiatives Nurse (CIN) is a senior nursing role to manage patients queuing in theED waiting room. The three priorities of the CIN role in the emergency department waitingrooms are:1. Review patients within their triage benchmark time to ensure they remain clinically safe2. Provide ongoing communication with the patient3. Initiate diagnostics or treatment with a particular emphasis on managing the patient’s pain(NSW Ministry of Health 2012). For detailed information about CIN, please refer to http://www.ecinsw.com.au/CINIt should be noted that this model may not be utilised in rural EDs where Registered Nursesin the rural sector may complete the First Line Emergency Care Course (FLECC). This courseprepares and credentials them as an Advanced Clinical Nurse (ACN) who can provide earlyappropriate management of acute and life threatening conditions, and relieve pain anddiscomfort for patients at hospitals where Medical Officers are not immediately available.More information can be found at:http://www.ecinsw.com.au/fleccWhy use the model?To improve the quality of care for patients in the waiting room. This includes reassessment ofwaiting room patients, early commencement of diagnostics and treatment andcommunication of wait times and ED processes.Key principles ■ Maintain a nursing presence in the ED waiting room to facilitate a safe clinicalenvironment■■■Communicate with patients and carers regarding ED processes and provision of relevanteducation on their health issuesAssess patients following triage with a view to:- initiate diagnostics or treatment (with a set end point)- escalate care, if required.Refer patients to appropriate services that may be external to the ED, for example aMedical Assessment Unit (MAU).Models of Emergency Care NSW HEALTH PAGE 15
Page 2 and 3: NSW MINISTRY OF HEALTH73 Miller Str
Page 4: Executive SummarySince the publicat
Page 7 and 8: 1.2 A review of Emergency Modelsof
Page 9 and 10: ■■■patients who need only a s
Page 11 and 12: SECTION 3Emergency Department Model
Page 13 and 14: In determining your skill mix requi
Page 15: Benefits of the model ■ Improved
Page 19 and 20: ■■Demonstrated ability to inter
Page 21 and 22: Predictive planning■■■■■
Page 23 and 24: 3.4 Acute Care2 hoursED Senior Asse
Page 25 and 26: What you need to runthe modelStaff
Page 27 and 28: Key principles ■ This is not a st
Page 29 and 30: Monitoring andevaluation■Waiting
Page 31 and 32: Challenges ■ Establishing guideli
Page 33 and 34: 3.7 Fast trackED Senior Assessment
Page 37 and 38: 3.8 Sub-acute2 hoursED Senior Asses
Page 39 and 40: 3.9 2 : 1 : 12:1:1This model requir
Page 41 and 42: Monitoring andevaluation■■■
Page 43 and 44: Why use the model?Key principlesBen
Page 47 and 48: SECTION 4Streamlining access to acu
Page 49 and 50: Challenges ■ Identification of
Page 51 and 52: ■■■Patient Flow pathways and
Page 53 and 54: Case for implementationWhat you nee
Page 55 and 56: Operating Principles■■■■■
Page 57 and 58: Case for implementationWhat you nee
Page 59 and 60: Mental Health LiaisonNursesApproxim
Page 61 and 62: 5.1 Urgent Care CentreThe Urgent Ca
Page 63 and 64: 5.3 Connecting CareWhat is the mode
Page 65 and 66: SECTION 7Self-Assessment ToolsInclu
Page 67 and 68:
NHS Gloucestershire 2006, UK Urgent
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Emergency Department Models of Care 2012 - NSW Health

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