Workflow chart criticism: "A patient arrives in the ER"
First and foremost, this workflow could benefit from a clearer title. The flow does not merely delineate what happens when a patient is admitted to the ER but rather what transpires when a patient with a suspected cardiac condition is admitted via emergency medical services. As well as a more coherent title, this workflow could benefit from greater description in the different boxes of the flow. While it is true that a workflow chart is designed to be relatively economical in terms of verbiage, this workflow needs greater explanation of acronyms such as 'CP via EMS.' It is unclear what CP refers to at first. Presumably it refers to a suspected cardiac patient but the meaning of the acronym is ambiguous given the title and the fact that CP could refer to a variety of different things.
The next square notes that the nurse conducts the initial interview, after which the patient is taken to the registration desk or to triage where he or she is submitted to an EKG and an assessment of his or her vital signs. The reason for such a split could be more clearly noted. For example, instead of "registration desk," it could be stated "non-emergency patient without cardiac condition (abbreviated non-CP) is sent to the registration desk" and instead of "triage EKG, VS" the box could more explicitly read "suspected cardiac patient triage,...
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But let's look at this resolution in a bit more depth. Briefly, processes like full capacity protocols, bedside registration, bypassing triage, adding staff during increased volume, setting up a separate "line" for treating simple fractures, lacerations, etc., establishing turn-around-time (TAT) goals for procedures and patients, can go a long way to begin to cure the problem of overcrowding (ACEP, 2008, p. 10). Full-capacity protocols. Here is a typical full-capacity protocol
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