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INNOVATIONS: Emergency department design

This comprehensive article, based on an extensive literature review, covers all sorts of operational innovations that hospitals are trying in order to improve their emergency departments, and then discusses the implications for facility design.  Data from the Emergency Department Benchmarking Alliance (EBDA) indicate that emergency departments with less than 20,000 annual visits do better on performance metrics than larger EDs, suggesting the consideration that larger EDs be broken into smaller functional units.  These smaller EDs could then be differentiated by acuity or chief complaint.  The concept of the Breathing ED,which means cyclically opening and closing portions of the ED according to patient load, is discussed.  Among the other concepts discussed include:

  • Triage models (should intake be done by physicians or teams instead of triage nurses?)
  • Triage pods
  • Care initiation areas
  • Low flow-high flow process model
  • Routine ordering of EKGs for patients with chest, neck, and abdominal symptoms
  • Pull to full
  • Fast track
  • Med teams
  • Geographic zones
  • Internal waiting rooms instead of housing patients in ED treatment rooms
  • Reclining chair units
  • Express admissions units
  • Discharge kiosks
  • Clinical decision units

Why I like this article:  It covers so many concepts in a thoughtful and well-researched fashion.

Source: Welch, S.J.  Using data to drive emergency department design: a metasynthesis.  HERD. Health Environments Research & Design Journal;5(3):26-45, Spr. 2012.  Click here for the publisher’s website: http://www.herdjournal.com/ME2/Default.asp  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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