Lesson+3+Evaluate+the+solutions

[|$7 million in renovations providing more than a facelift]

The solutions recommended vary on difficulty and effectiveness. Some recommendations such as, the sticker technique provide minimal quantitative effectiveness, however expanding PACe and utilizing our recommendation of using volunteers or part timers, as runners to the doctors and transporting patients from Triage to PACe would be monumental. For this system to work administration and subsequently the reader must believe in keeping skilled people in their position of expertise. If Grady continues to use RNs to transport patients and provides to find doctors to sign off on paper work they are taking skill people and putting them in unskilled jobs. This renders them ineffective for that given timer period. We must all assume that people will perform best in areas they are trained to do. This system would also prevent social loafing.

Other recommendations are important but offer structural changes and will most likely not be implemented during the time of this project, however would be important in changing the effectiveness of the ECC overall (like moving non-emergent care out of an access controlled area).

As everyone is aware, emergency rooms are not the most efficient places in health care. Most patents are forced to wait multiple hours for a chance to be repaired or told to go somewhere else. Grady is no exception to these problems. Triage and PACe are overwhelmed with patents and the current structure is unable to keep up with old (and standardized) times while keeping policy the same. Our group has decided to recommend specific policy changes an in attempt to curb the latencies of wait time.


 * Have the patients be escorted down from triage by someone other than a PACe unit nurse (a volunteer perhaps). This would ensure that the nurses within PACe are constantly treating patients and having a low turnaround rate.
 * Implement an EHR to eliminate the amount of paperwork associated with the patient’s care. Once intake is completed, the nurse or provider would only have to add in additional comments about the diagnosis. Also, discharge could be as simple as one click.
 * Have providers fill our paperwork as they see the patient in the rooms. This would decrease the time patients must wait for discharge (current system seems to be that paperwork is filled out in bunches of 3-5).
 * Designate a nurse or provider to talk with doctors over treatment. The current system takes a long time for providers to talk with doctors, sometimes it doesn’t happen at all. Alternately, PACe could have a doctor make a stop into different ECC departments periodically.
 * Chart patient seen in a shift amount by shift instead of person. Current charting system discourages competition, and might even increase misdiagnosis or unfavorable patient swapping during shift change.
 * Place Stickers on folders designated for certain rooms. There is currently stickers showing which slot the folders go in but stickers on the folders themselves might help organization during busy times. Moreover, maybe a red sticker on a folder designated for sexual assault victims so these records can be easily found by providers and law enforcement.
 * In the future, PACe could provide a secondary waiting room to free up space while patients wait for lab work. There are few rooms and the current system creates a backlog of an hour or more in most cases.
 * Have the patient’s fill out the detailed patient information while receiving care in PACe care rather than doing so after Triage. This will save a valuable amount of time and free up space in the ECC.

The hyperlinked article above provides an example of how structural changes have increased efficiency in the ECC. These improvements include: more beds/rooms, moving departments around, and general cosmetic upgrades. These are recommendations offered in the previous article and above.

Works Cited:

Davis, Bev. "$7 million in renovations providing more than a facelift." //register-herald//. N.p., 7 Nov. 2009. Web. 7 Nov. 2009. 