sop emergency department

7/25/2019 SOP Emergency Department

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(CRS) MillenniumTrust Standard Operating Procedures:

Emergency Department

Index:

18 Emergency Department_________________________________________2

!" #usiness Rules $or Emergency Department%%%%%%%%%%%%%%%%%%%%%%%%%%%%&

!"& Emergency Department Process Maps%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%&

!"' ED Registration * ED%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%&18.3.1 ED001 Scope________________________________________________________218.3.2 ED001 Roles and Responsibilities________________________________________2

18.3.3 ED001 Process Map___________________________________________________3!"+ ED & ,dmission to M,- or S,-%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%+

18.4.1 ED002 Scope________________________________________________________418.4.2 ED002 Roles and Responsibilities________________________________________418.4.3 ED002 Process Map___________________________________________________5

!". ED ' ,dmission to O/s 0ard%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%118.5.1 ED003 Scope________________________________________________________618.5.2 ED003 Roles and Responsibilities________________________________________6

18 5 3 ED003 P M 7



18 5 3 ED003 P M 7

! Emergency DepartmentProcess O7ner: Deputy Di8isional Manager MedicineProcess 3ead: ED ,dmin Manager9ED 3ead Clinician

!" #usiness Rules $or Emergency Department

1. ED Reception to add a red stic er to t#e '!S'!RD i/ an alert &arnin,appears &#en creatin, t#e ED enco"nter.

2. ED 'linicians to re ie& t#e alert and )odi/- add ne& alerts &#en re "ired.3. Patient Re,istration r"les appl- /or all ED patients.

!"&Emergency Department Process Maps

• ED001 Re,istration ED• ED002 !d)ission to M! or S!• ED003 !d)ission to +bs 9ard• ED004 Send to :#eatre or 'at# %ab• ED005 Disc#ar,e• ED006 +P appoint)ent• ED007 Patient location en "ir-• ED008 'linical !ssess)ent



!"'"' ED Process Map

ED001$ Re,istration ED

E D

' l i n i c i a n

E D

R e c e p

t i o n

i s t

PM+'reate EDenco"nter

Does patientneed

ad)ittin,>

Does t#epatient needtreat)ent>

Patient :reat)ent

P: <?RS:?np"t clinicalin/or)ation

Does t#epatient need

an < P or +Pappoint)ent>

@es

Ao

@es

Ao

@es

Ao

Patient sent toappropriate

&aitin, area.

!lert onpatient>

!ttac# red dot to'!S '!RD@es

Ao

I:P

I:P

:o ED005Disc#ar,e ED

:o ED004 Send to t#eatre +r cat# lab

Re/er to ED006 +P !ppoint)ent

Re/er to ED008'linical

!ssess)ent

<ro) BM00 aE)er, re/

)edicine 7CP liaison n"rse

Start

:o ED002 !d)ssion to

M!+r S!

:o ED003 !d)ission to +bs &ard

<ro) BM010aE)er, re/

s"r,er- 7pri)ar-

De)o ?ndep :rainin, Materials

Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust. If any process does not support operational practice or RUH Policy email details here

Millennium Model

!"t#or$ %isa %e&is 'RS (Millenni")* S+P$ E)er,enc- Depart)ent 22 "l- 2011Pa,e 3 o/ 20



!"+ED & ,dmission to M,- or S,-

!"+" ED & Scope

• Process to )ana,e t#e allocation o/ an inpatient bed /or an ED patient

!"+"& ED & Roles and Responsi/ilities

Roles Responsi/ilities

ED 'linician • Re "est bed on patient /irst

• Disc#ar,e patient in patient /irst

M! S! • !llocate bed on patient /irst

Porter • :rans/er patient

ED Receptionist • Scan '!S card



!"+"' ED & Process Map

ED002$ !d)ission to M! or S! ED

P o r t e r

E D

' l i n i c i a n

E D

R e c e p t i o n i s t

M ! 8 4 S ! 8

<ro) ED001Pateint

Re,istration

P: <?RS:Re "est Bed P#one M! S!

P: <?RS: !llocate Bed

A"rse #ands o erpatient to M!

S!

P: <?RS:Disc#ar,e

patient

Scan 'as cardand place in

patient notes i/a ailable

:R:rac notes i/appropriate

:ransport patientto M! S!

:o ?P001a !d)it Patient

I P I P

p De)o ?nde :rainin, Materials


Millennium Model




!".ED ' ,dmission to O/s 0ard

!"." ED ' Scope

• Process to )ana,e t#e allocation o/ a bed in t#e ED obser ation "nit

!"."& ED ' Roles and Responsi/ilities


ED 'linician • Disc#ar,e patient in patient /irst

ED +bs 9ard Sta// • !d)it patient ()illenni")*

• Disc#ar,e patient ()illenni")*

• :rans/er patient ()illenni")*

ED A"rse Doctor !' • 'o)plete F:E assess)ent ()illenni")*



!"."' ED ' Process Map

ED003$ !d)ission to +bs 9ard ED

E D ' ! 4

A " r s e

4 D o c t o r

E D R e c e p t i o n i s t 4

+ b s 9 a r d

S t a / /

E D ' l i n i c i a n

PM+ !d)it patient

to +bs

<ro) ED001Re,istration

ED

P: <?RS::rans/er pt to

+bs 9ard

I P

Aoti/- +bs o/e pected patient

Pt to bedisc#ar,ed>

PM+Disc#ar,e Pt

:o ?P002:rans/er &ard

or 'ons"ltantand bed s&ap

@es End

P''o)plete F:Eand ?nitial Ris !ssess)ents

Ao



Millennium Model




!"1ED + Send to T2eatre or Cat2 3a/

!"1" ED + Scope

• Process to )ana,e t#e ad)ission o/ a patient to an inpatient bed /ro) ED

!"1"& ED + Roles and Responsi/ilities


ED Reception • Disc#ar,e Patient on Patient <irst

<orrester Bro&n '' S!&ard sta//

• !d)it patient



!"1"' ED + Process Map

ED004$ Send to :#eatre 'at# lab 6 ED

: # e a t r e

' ' 8 4 < o r r e s t e r B r o & n 9 a r d

S t a / /

E D R e c e p t i o n i s t

'ontact :#eatreb- p#one to in/or)

t#e) o/ t#ee pected s"r,er-.

ando3er tot#eatre

P: <?RS:Disc#ar,e

patient

Scan '!S cardand p"t into

patient notes.

Rin, t#eatre toarran,e ti)e /or

trans/er.

Patient trans/erredto t#eatre

<ro) ED001

Re,istration6 ED

:o M:007

E)er,enc-Sc#ed"lin, :#eatre 1

:o ?P001aAon Electi3e

!d)ission

I:PI:P

p :rainin, MaterialsDe)o ?ndeMillennium Model

P: <?RS:Place

Pendin, !d)ission


!"t#or$ %isa %e&is 'RS (Millenni")* S+P$ E)er,enc- Depart)ent 22 "l- 2011Pa,e o/ 20



!"4ED . * Disc2arge

!"4" ED . Scope

• Process /or disc#ar,in, t#e ED enco"nter

!"4"& ED . Roles and Responsi/ilities


ED 'linician • Disc#ar,e Patient on Patient <irst

• Disc#ar,e s"))ar- prod"ced /ro) Patient<irst

ED Reception • !rran,e /ollo& "p +P appoint)ent i/ re "ired()illenni")*



!"4"' ED . Process Map

ED005$ Disc#ar,e ED

S - s t e )


E D ' l i n i c i a n

Patient dee)ed /it/or disc#ar,e orsel/ disc#ar,e

P: <?RS:Patient

disc#ar,ed

<ollo& "pappoint)ent

re "ired>Ao

@es

Disc#ar,e letter,enerated

%etter posted'!S card scanned

and destro-edaccordin, to polic-

End

<ro)ED001

Re,istration ED

I PP: <?RS:Disc#ar,eS"))ar-co)pleted

Re/er toED006

+P !ppoint)ent

<ro)ED008'linical

!ssess)ent ED

I P

p De)o ?nde :rainin, Materials

If any process does not support operational practice or RUH Policy email details hereNote: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.

Millennium Model




!"!ED 1 OP ,ppointment

!"!" ED 1 Scope

• Process /or arran,in, a /ollo& "p appoint)ent in o"tpatients /ollo&in, a isitto ED

!"!"& ED 1 Roles and Responsi/ilities


ED Receptionist • 'reate Enco"nter

• Sc#ed"le appt (i/ slots a ailable*

• :rac case notes

<ract"re 'linic • Monitor &aitin, list

• Sc#ed"le appoint)ent



!"!"' ED 1 Process Map

ED006$ +P !ppoint)ent

< r a c t " r e

' l i n i c


E D


Does patient needMa = EA: or E-e

appt>

Ao

Details are /a edor sent.@es

:R:rac notes i/

appropriate

Patient re "ires+ P /ract"re clinic

?s slota ailable>

PM+'reate +PEnco"nter

?n/or) patient

Ao

<ro)ED007

Disc#ar,e

S!BBoo

!ppoint)ent

S!BBoo

appoint)ent

:o +P002Record

attendance

End

@es

PM+Monitor

&aitin, list(re/erral*

:rainin, Materials8p De)o ?nde


Millennium Model




!"5ED 4 Patient 3ocation En6uiry

!"5" ED 4 Scope

• Process /or locatin, a patient &it#in ED or &it#in t#e )ain #ospital

!"5"& ED 4 Roles and Responsi/ilities


ED Reception • ?denti/- patient &it#in t#e #ospital "sin, PM%ocator ()illenni")

• ?denti/- patient &it#in ED "sin, Patient /irst



!"5"' ED 4 Process Map

ED007$ Patient %ocation En "ir- ED


Start !s /or data &it#in

data protection,"idelines

ED Patient>Patient

Searc# onPatient <irst

PM+%a"nc#Patient%ocate

Ao

@es EndPatient

%ocated

Ao

@es

'all recei eden "irin, patient

stat"s

p :rainin, MaterialsDe)o ?ndeMillennium Model





!" ED ! Clinical ,ssessment

!" " ED ! Scope

• Process /or doc")entin, clinical /indin,s d"rin, isit to ED

!" "& ED ! Roles and Responsi/ilities


ED 'linician • Doc")ent /indin,s in Patient <irst

• Doc")ent alerts in Millenni")



!" "' ED ! Process Map

ED008$ 'linical !ssess)ent 6 ED

' l i n i c i a n

Patient #as /"llassess)ent b-

clinician.

Blood /or)co)pleted be/orebloods are ta en.

@es

@es

?'E'#ec blood

res"lts

P!'SRes"lts

recei3ed

Patientre "ires bloods

to be ta en>

Patientre "ires

6ra->

?s patient to bere3ie&ed b-

specialit-

@es

P: <?RS:G6ra- or ':re "ested

<ro)ED001

Re,istration6 ED

?s t#ere a 'RSalert on pt

record>

P''#ec !lert

Proble)re "ires an

entr- in 'RSrecord>

@es

!ppropriate actionta en

P: <?RS:'linical/indin,s

doc")ented

Ao

P#one bleep Dr oncall

P'pdate

patients c#art

@es

Ao

: o ED005Disc#ar,e6 ED

Ao

Ao

Ao

:rainin, MaterialsDe)o ?ndep


Millennium Model




!" ED 5 -ndo Disc2arge

!" " ED 5 Scope

!" "& ED 5 Roles and Responsi/ilities


•



!" "' ED 5 Process Map

ED00 $ ndo disc#ar,e ED

R e c e p

t i o n

i s t

E D

' l i n i c i a n

<ro) ED005Disc#ar,e

ED

PM+ndo

Disc#ar,e'on erstaion

Reception noti/iedo/ disc#ar,e error

P: <?RS:Patient reacti ated

:o ED008'linical

!ssess)ent orED005 D ' Pt

I P

:o ED008 'linical !ssess)ent ED

:o ED005Disc#ar,e ED

I P



Millennium Model


sop emergency department

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