Emergency Department Models of Care 2012 - NSW Health

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Monitoring andevaluation■■■■■■■■■Waiting time for treatment by triage categoryAverage ED LOSETZ LOSOccasions of patient breaches of 2-hour targetOccasions in which model is activated/openedNational Emergency Access Target (4-hour target)Patient outcomes and incidentsPatient satisfaction and complaintsStaff feedback.The ETZ is included in the Early ED SAS Model of Care and Implementation Toolkit. Moredetail about the ED SAS MOC and implementation toolkit can be accessed from ARCHI atwww.archi.net.au and the ECI at www.ecinsw.com.au/edsusPAGE 30 NSW HEALTH Models of Emergency Care
3.7 Fast trackED Senior Assessment StreamingTriageRegistration2 hoursFast trackWhat is the model?Why use the model?Fast track is a dedicated area in the ED to treat ambulant, non-complex (single systemproblem) patients who can be discharged within < 2 hours. Triage streams patients into theFast Track using a pre-determined inclusion/exclusion fast track criterion.Fast Track zones aim to increase ED throughput by:■■■■■Expediting the care of ambulatory patients with less urgent complaints (Al Darrab et al,2006; Considine et al 2010)Diverting the care of patients who meet particular clinical criteria through a separatestream in the ED (Ieraci et al, 2008)Using a geographically dedicated area staffed by dedicated senior medical and nursingstaff (Considine et al 2010)Dedicated senior medical and nursing staff working to optimise the performance of fasttracksystems as they have the ability to make timely treatment and disposition decisionswith minimal consultation (Considine et al 2010)Providing care that is standardised and targeted to specific conditions and injuries.Fast Track zones provide an alternative option to treat non-complex patients in a timelymanner, reducing long waiting times for minor problems.A study by Ieraci et al (2008) demonstrated a reduction in the mean waiting time for fasttrack patients from 55 minutes to 32 minutes and a reduction in the mean treatment timefrom 209 to 191 minutes.Key principles ■ Expedite the journey for less-urgent / non-complex patients■ Use dedicated staff (Ieraci 2008)■■■■■■■■Operating hours should reflect high demand periods (Considine et al 2010) – in some EDs,demand may be sufficient for Fast Track to operate as 24-hour seven day per weekservice.Uses quarantined space where patients are treated in a dedicated area by dedicated staffCommence treatment earlyStrict inclusion and exclusion criteria supported by business rulesClinical protocols that promote early initiation of nursing careRapid access to appropriate imaging and pathologyPatients with a single system problem that can be discharged in < 2 hoursEasy access to specialty outpatient, GP and community care referral services.Models of Emergency Care NSW HEALTH PAGE 31
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 and 16: Benefits of the model ■ Improved
Page 17 and 18: 3.2 Clinical Initiatives NurseResus
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: Challenges ■ Establishing guideli
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

Emergency Department Models of Care 2012 - NSW Health

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