(CRS) Millennium Trust Standard Operating Procedures: Emergency Department Index: 18
Emergenc Emergency y Departmen Department____ t_______ _______ _______ _______ ________ _______ _______ ________ ________ ________2 ____2
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#usiness #usiness Rules Rules $or Emergency Emergency Departme Department%% nt%%%%%% %%%%%%%% %%%%%%% %%%%%% %%%%%%% %%%%%%%% %%%%%%% %%%%& %&
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Emergency Department Process Maps%%%%%% Maps%%%%%%%%% %%%%%% %%%%%%% %%%%%%% %%%%%% %%%%%%% %%%%%%% %%%%%%%& %%%%&
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ED ED Registrat Registration ion * ED%%%%%% ED%%%%%%%%% %%%%%%% %%%%%%%% %%%%%%% %%%%%%% %%%%%%% %%%%%%% %%%%%%% %%%%%% %%%%%%% %%%%%%& %%&
18.3.1 18.3.1 18.3.2 18.3.2 18.3.3 18.3.3
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ED& ED& ,dmiss ,dmission ion to M,M,- or S,-% S,-%%%%% %%%%%%%% %%%%%%% %%%%%%% %%%%%%%% %%%%%%% %%%%%% %%%%%%% %%%%%%%% %%%%%+ %+
18.4.1 18.4.1 18.4.2 18.4.2 18.4.3 18.4.3
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ED001 ED001 Scope__ Scope_____ _______ ________ ________ ________ _______ _______ _______ ______ _______ ________ ________ ________ ________ ______2 __2 ED001 ED001 Roles Roles and Responsi Responsibili bilities_ ties_____ _______ _______ ________ ________ ________ _______ _______ _______ ______ ______2 ___2 ED001 ED001 Process Process Map___ Map______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______3 ___3 ED002 ED002 Scope__ Scope_____ _______ ________ ________ ________ _______ _______ _______ ______ _______ ________ ________ ________ ________ ______4 __4 ED002 ED002 Roles Roles and Responsi Responsibili bilities_ ties_____ _______ _______ ________ ________ ________ _______ _______ _______ ______ ______4 ___4 ED002 ED002 Process Process Map___ Map______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______5 ___5
ED' ,dmission to O/s 0ard%%%%% 0ard%%%%%%%%% %%%%%%%% %%%%%%%% %%%%%%%% %%%%%%%% %%%%%%%% %%%%%%%% %%%%%%%% %%%%%1 %1
18.5.1 18.5.1
ED003 ED003 Scope__ Scope__
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! Eme Emerge rgency ncy Departme Department nt Process O7ner: Deputy Di8isional Manager Medicine Process 3ead: ED ,dmin Manager9ED 3ead Clinician
!"#usiness Rules $or Emergency Department 1. ED Recep Recepti tion on to add add a red red stic stice err to t#e '!S'!R '!S'!RD D i/ an ale alert rt &arni &arnin, n, appears &#en creatin, t#e ED enco"nter. 2. ED 'linician 'linicians s to reie& t#e t#e alert and and )odi/-add )odi/-add ne& alerts alerts &#en &#en re"ired. re"ired. 3. Patient Patient Re,istrat Re,istration ion r"les r"les applappl- /or /or all ED ED patients. patients.
!"&Emergency Department Process Maps • • • • • • •
ED001 Re,istration ED ED002 !d)ission to M! or S! ED003 !d)ission to +bs 9ard ED004 Send to :#eatre or 'at# %ab ED005 Disc#ar,e ED006 +P appoint)ent ED007 Patient location en"ir-
!"'"' ED Process Map
ED001$ Re,istration ED Millennium Model
t s i n o i t p e c e R D E
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!ttac# red dot to '!S '!RD
I:P
PM+ 'reate ED enco"nter
:o ED004 Send to t#eatre +r cat# lab
!lert on patient>
Ao
Start
:o ED002 !d)ssion to M! +r S!
:o ED003 !d)ission to +bs &ard
Patient sent to appropriate &aitin, area. @es Re/er to ED006 +P !ppoint)ent
Re/er to ED008 'linical !ssess)ent
I:P
Does patient need ad)ittin,>
@es
P:
Ao
n a i c i n i l ' D E
Does t#e patient need treat)ent>
Ao
Does t#e patient need an <P or +P appoint)ent>
:o ED005 Disc#ar,e ED
Ao
@es Patient :reat)ent
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If any process does not support operational practice or RUH Policy email details here
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 3 o/ 20
22 "l- 2011
!"+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 ED 'linician
Responsi/ilities
•
Re"est bed on patient /irst
•
Disc#ar,e patient in patient /irst
M!S!
•
Porter
•
!llocate bed on patient /irst
:rans/er patient
!"+"' ED& Process Map
ED002$ !d)ission to M! or S! ED Millennium Model
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p
8 ! S 4 8 ! M n a i c D i E i n l '
:rainin, Materials
P:
:o ?P001a !d)it Patient
IP
IP P:
P#one M!S!
A"rse #ands oer patient to M! S!
P:
r e t r o P
:ransport patient to M!S!
t s i n o i t D p E e c e R
Scan 'as card and place in patient notes i/ aailable
Note: Copyright 2011Bernadette Burt, Royal United Hospital, Bath NHSTrust.
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:R :rac notes i/ appropriate
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'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 5 o/ 20
22 "l- 2011
!".ED' ,dmission to O/s 0ard !"." ED' Scope •
Process to )ana,e t#e allocation o/ a bed in t#e ED obseration "nit
!"."& ED' Roles and Responsi/ilities
Roles
Responsi/ilities
ED 'linician
•
ED +bs 9ard Sta//
•
ED A"rseDoctor!'
Disc#ar,e patient in patient /irst
!d)it patient ()illenni")*
•
Disc#ar,e patient ()illenni")*
•
:rans/er patient ()illenni")*
•
'o)plete F:E assess)ent ()illenni")*
!"."' ED' Process Map
ED003$ !d)ission to +bs 9ard ED Millennium Model n a i c i n i l ' D E
p
De)o ?nde
:rainin, Materials
IP
P:
d r a 9 s b + 4 t / s / i a n t o S i t p e c e R D E
Aoti/- +bs o/ epected patient
PM+ !d)it patient to +bs
:o ?P002 :rans/er &ard or 'ons"ltant and bed s&ap Ao
Pt to be disc#ar,ed>
r o 4 t ! c o ' D 4 e D s E r " A
@es
PM+ Disc#ar,e Pt
End
P' 'o)plete F:E and ?nitial Ris !ssess)ents
Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.
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'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 7 o/ 20
22 "l- 2011
!"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
Roles
Responsi/ilities
ED Reception
Bro&n''S!
•
•
Disc#ar,e Patient on Patient
!d)it patient
!"1"' ED+ Process Map ED004$ Send to :#eatre'at# lab 6 ED Millennium Model
t s i n o i t p e c e R D E
/ / a t S d r a 9 n & o r B r e t s e r r o < 4 8 ' '
p
De)o ?nde
:rainin, Materials
'ontact :#eatre b- p#one to in/or) t#e) o/ t#e epected s"r,er-.
I:P
I:P
P:
Rin, t#eatre to arran,e ti)e /or trans/er.
P:
Scan '!S card and p"t into patient notes.
Patient trans/erred to t#eatre
ando3er to t#eatre
:o ?P001a Aon Electi3e !d)ission
e r t a e # :
:o M:007 E)er,encSc#ed"lin, :#eatre 1
Note: Copyright 2011Bernadette Burt, Royal United Hospital, Bath NHS Trust.
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If any process does not support operational practice or RUH Policy email details here
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e o/ 20
22 "l- 2011
!"4ED. * Disc2arge !"4" ED. Scope •
Process /or disc#ar,in, t#e ED enco"nter
!"4"& ED. Roles and Responsi/ilities
Roles ED 'linician
Responsi/ilities
•
•
ED Reception
•
Disc#ar,e Patient on Patient
!"4"' ED. Process Map
ED005$ Disc#ar,e ED Millennium Model
De)o ?nde
p
IP
IP
n a i c i n i l ' D E
t s i n o i t p e c e R
Patient dee)ed /it /or disc#ar,e or sel/ disc#ar,e
Ao
:rainin, Materials
P:
P:
@es
Re/er to ED006 +P !ppoint)ent
) e t s S
%etter posted
'!S card scanned and destro-ed accordin, to polic-
End
Disc#ar,e letter ,enerated
Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.
!"t#or$ %isa %e&is
If anyprocessdoesnotsupportoperationalpracticeorRUHPolicy emaildetailshere
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 11 o/ 20
22 "l- 2011
!"!ED1 OP ,ppointment !"!" ED1 Scope •
Process /or arran,in, a /ollo& "p appoint)ent in o"tpatients /ollo&in, a isit to ED
!"!"& ED1 Roles and Responsi/ilities
Roles ED Receptionist
Responsi/ilities
•
'reate Enco"nter
•
Sc#ed"le appt (i/ slots aailable*
•
:rac case notes
•
Monitor &aitin, list Sc#ed"le appoint)ent
!"!"' ED1 Process Map
ED006$ +P !ppoint)ent Millennium Model
De)o ?nde
8p
:rainin, Materials
t s i n o i t p e c e R D E
Does patient need Ma= EA: or E-e appt>
@es
Details are /aed or sent.
:R :rac notes i/ appropriate
PM+ 'reate +P Enco"nter
?s slot aailable>
End
Ao
Patient re"ires +P /ract"re clinic
@es
S!B Boo !ppoint)ent
?n/or) patient
S!B Boo appoint)ent
:o +P002 Record attendance
Ao
c t i s n i i l n ' i o t e r p " e t c c e a r R <
PM+ Monitor &aitin, list (re/erral*
Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.
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If any processdoes not support operational practice or RUHPolicy email details here
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 13 o/ 20
22 "l- 2011
!"5ED4 Patient 3ocation En6uiry !"5" ED4 Scope •
Process /or locatin, a patient &it#in ED or &it#in t#e )ain #ospital
!"5"& ED4 Roles and Responsi/ilities
Roles ED Reception
Responsi/ilities
•
•
?denti/- patient &it#in t#e #ospital "sin, PM %ocator ()illenni") ?denti/- patient &it#in ED "sin, Patient /irst
!"5"' ED4 Process Map
ED007$ Patient %ocation En"ir- ED Millennium Model
Start
t s i n o i t p e c e R
p
!s /or data &it#in data protection ,"idelines
De)o ?nde
ED Patient>
:rainin, Materials
@es
Patient Searc# on Patient
Patient %ocated
@es
End
'all receied en"irin, patient stat"s
Ao
Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.
!"t#or$ %isa %e&is
PM+ %a"nc# Patient %ocate
Ao
If anyprocessdoesnotsupportoperationalpracticeorRUHPolicy emaildetailshere
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 15 o/ 20
22 "l- 2011
!" ED! Clinical ,ssessment !"" ED! Scope •
Process /or doc")entin, clinical /indin,s d"rin, isit to ED
!""& ED! Roles and Responsi/ilities
Roles ED 'linician
Responsi/ilities
•
Doc")ent /indin,s in Patient
•
Doc")ent alerts in Millenni")
!""' ED! Process Map ED008$ 'linical !ssess)ent 6 ED Millennium Model
De)o ?nde
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:rainin, Materials
?s t#ere a 'RS alert on pt record>
Ao
Patient re"ires bloods to be taen>
@es
Blood /or) co)pleted be/ore bloods are taen.
?'E '#ec blood res"lts Patient #as /"ll assess)ent bclinician.
Ao @es
n a i c i n i l '
Patient re"ires 6ra->
@es
P:
P!'S Res"lts recei3ed
P:
Proble) re"ires an entr- in 'RS record>
P' '#ec !lert
Ao
Ao @es
P' pdate patients c#art
!ppropriate action taen
?s patient to be re3ie&ed bspecialit-
@es
P#onebleep Dr on call
Ao
: o ED005 Disc#ar,e 6 ED
Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.
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If any process does not support operational practice or RUH Policy email details here
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 17 o/ 20
22 "l- 2011
!"
ED5 -ndo Disc2arge
!"" ED5 Scope
!""& ED5 Roles and Responsi/ilities
Roles
Responsi/ilities
•
!""' ED5 Process Map
ED00$ ndo disc#ar,e ED Millennium Model
De)o ?nde
p
:rainin, Materials
IP
n a i c i n i l ' D E
t s i n o i t p e c e R
P:
:o ED008 :o ED008 'linical 'linical !ssess)ent or !ssess)ent ED ED005 D' Pt
:o ED005 Disc#ar,e ED
IP Reception noti/ied o/ disc#ar,e error
Note: Copyright 2011 Bernadette Burt, Royal United Hospital, Bath NHS Trust.
!"t#or$ %isa %e&is
PM+ ndo Disc#ar,e 'onerstaion
If anyprocessdoesnotsupportoperationalpracticeorRUHPolicy emaildetailshere
'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 1 o/ 20
22 "l- 2011
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'RS (Millenni")* S+P$ E)er,enc- Depart)ent Pa,e 20 o/ 20
22 "l- 2011
