Admin models

Question 1

5 steps for best practice in Discharge Against Medical Advice

Answer 1

-explore and address reasons for wishing to discharge
-assess capacity to make decision
-explain risks of discharge
-offer alternative treatment and safety netting
-documentation

Question 2

Framework for Hot Debrief

Answer 2

STOP!
Summarise case
Things that went well
Opportunities to improve
Points of action going forward

Question 3

Define ED overcrowding

Answer 3

Situation where ED function is impeded primarily because the number of patients waiting to be seen, undergoing assessment and treatment, or waiting to leave exceeds the physical and/or staffing capacity of the ED

Question 4

7 causes of ED overcrowding

Answer 4

-access block
-increased patient numbers
-increased patient complexity
-increased unnecessary investigation
-delays in inpatient unit assessment
-delay in other services- radiology/ pathology/ physiotherapy/ social work
-ED staff factors- low number and inexperienced skill mix
-ED physical design- size

Question 5

Define access block

Answer 5

Inability to access appropriate beds in a timely manner for emergency patients who require inpatient admission

Question 6

3 recommendation by ACEM to ensure more effective and efficient care in ED

Answer 6

-demand reduction- eg access to outpatient clinics/ easier referral processes
-remove barriers to patient flow- pull model, minimise ED investigations
-reduce hospital occupancy- improved discharge planning, HITH