Emergency Department Models of Care 2012 - NSW Health

3.4 Acute Care2 hoursED Senior Assessment Streaming Early Treatment ZoneTriageRegistrationAcuteWhat is the model?Why use the model?The Acute Care Model of Care is a set of principles and processes that aim to promoteefficiency in initiating, assessing, performing and transferring the care of patients who areacute, potentially unstable and complex. These are patients that require:■■■■■Cardiac monitoringFrequent observationSpecialised interventionsA higher level of careA more comprehensive management plan.An Acute Care MOC is essential in all EDs to:■■■■■Focus on the optimal treatment of acutely ill patientsProvide access to acute care in a timely mannerPromote initial assessment by senior physician decision maker, allowing focussedinvestigations and treatment, and reducing any duplication of work between Junior andSenior Medical Officers, and other clinical providers (for example, CIN)Improve turnaround time for diagnostics and specialist reviewStandardise processes for consistent results.Key Principles ■ An initial senior assessment by a senior ED Physician to establish the patient managementplan and likely disposition■■■■■■■Adoption of a team approach to patient managementTimely access to specialist consultants and diagnostic turnaround timesCoordination of care using clinical pathways (for example, chest pain pathway, sepsispathway)Promoting a culture to regularly review patients to progress them to the next point ofcareA standardised process for handover of patients from ED medical staff to inpatient orcommunity medical staffCompliance with policies supporting the timely movement of admitted patients from theED to an inpatient unitA standardised clinical environment for each acute bed, that is, each bed area is setupand stocked with standardised equipment and organised using the principles of leanthinking.Models of Emergency Care NSW HEALTH PAGE 21