Emergency Department Models of Care 2012 - NSW Health

Challenges ■ Inappropriate placement of patients in the ED SSU. Examples are:- The EDSSU being used as a holding bay for patients awaiting bed allocation on the ward- The EDSSU being used as a way to improve KPIs, for example, transfer of care times.■■Pressure from hospital executives to use ED SSU beds for hospital inpatient care or thebackwards flow of patients to ED, for example, patients from Intensive Care Units whoare unable to access an inpatient general ward bed.If the EDSSU is physically located too far away from the ED it can impede patient flow.Despite the best intentions to place appropriate patients in the EDSSU who will be dischargedwithin 24 hours, a proportion of these patients will require admission to an inpatient unit.Monitoring of the number of these patients and reasons for failure is imperative, as isrecognition that a failure rate in the order of 10–15% is desirable to ensure suitable patientsare not missed.Case for implementationTo assess the need to implement this model in your ED, consider the following:■■■■■Is there inefficient patient flow?What is the proportion of patients assessed and treated in your ED that require amaximum stay of 24 hours to complete treatment?Does your ED treat patients who experience a long length of stay?What is the proportion of patients discharged from an inpatient unit within 24–48 hoursof admission from ED? (These patients may have been better managed in an EDSSU.)Is your ED meeting the 4-hour National Emergency Access Target?PAGE 42 NSW HEALTH Models of Emergency Care