>From: "Al-Asfoor" <[log in to unmask]>
>So many told about reducing waiting time and treating minor injuries.
>
>In my humble opinion, minor illnesses should not present to A&E
>departments.
>and if they did, the A&E triage will assess if they will be treated in the
>department when the doctors are ready or they will be redirected or advised
>to visit primary care centres immediately or sometime later.
>
>In our Department, we used to get a daily registered visits of ~700-900
>patients until around one year ago where nursing staffs were triaging at
>that time. Now we have 1-2 A&E doctors (depending on busy hours) doing the
>triage. registered patients reduced to around 300-400/day. The rest either
>redirected to local health centre (primary care) or given treatment (if
>found necessary) by the triaging doctor if after midnight when all local
>health centres are closed.
There is a small problem... Not all untrained persons can decide correctly
whether they have a "minor illness". Note that, in your department for
example, it took 1-2 doctors to decide that they had minor illness and could
be re-directed, while your nursing triage system was unable to do so. And if
professional nurses could not decide, how could the patients?
I have worked in departments which provide doctor triage and in others with,
as effective nurse-provided triage, but with the ability to tell patients to
go elsewhere. I have found, personally, that in such systems there is a
higher likelyhood of someone being sent away, after a cursory look-over by a
doc/nurse and later falling into unfortunate outcomes. Not saying mistakes
are not made after a full A&E visit, but we all know how occasionally
"minor" compliants rapidly become big ones.
In many areas, most of the UK included, GP's are already stretched to the
limit and beyond, despite A&E taking care of at least some work that your
system will diver to GP's. In your set-up, was there any study of or
provision for the increased workload at the primary care level? Is it being
included in the outcome evaluation you mention? Have you had any feed-back
from your GP's yet?
>
>This process has a second part which is "public education" through media
>and
>other ways. At the end this is all under evaluation and we are looking for
>the outcome.
>
>This is only in short....
>
>Dr. Mohamed Al-Asfoor,
>A&E Resident,
>A&E Department,
>Salmaniya Medical Complex,
>Bahrain
>
>If you'd like visit this free classified ads site for Bahrain:
>www.bab-albahrain.com
>
>
>
>
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