> Doctor triage seems to me an attractive idea.   Eyeballing the patient,
> organizing investigations without necessarily following these through
> personally,  re-routing those best seen elsewhere,

Referred to as "power rounds" on a previous episode of ER. And if it is on
ER then it must be good :-)

Simon

Simon Carley
SpR in Emergency Medicine
[log in to unmask]
Evidence based emergency medicine
http://www.bestbets.org
----- Original Message -----
From: "Paul Ransom" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, March 17, 2002 9:51 PM
Subject: Re: Initial medical assessment


> 'In Leeds,  the involvement of senior clinical staff in A&E in a patient's
> assessment from an early stage minimses waiting and ensures appropriate
> care.  Research shows that this can reduce the number of patients with
> emergency needs who re admitted to hospital by between 10 and 20%.'
>
> Reforming Emergency Care Document
>
> Anyone from Leeds out there  working this at the moment  ?   Does it work
?
> What is the 'research' ?   Is this about senior involvement in majors and
> minors ?   To institute this in all hospitals 16 hours a day will take far
> more than 183 new consultants in the UK by 2004.
>
> Doctor triage seems to me an attractive idea.   Eyeballing the patient,
> organizing investigations without necessarily following these through
> personally,  re-routing those best seen elsewhere, could be done pronto by
> staff grade / Spr / Consultant.  At the moment, there are not the staffing
> levels,  but possibly an escalation policy,  so that this could be started
> if patient numbers increase above a certain level. Or sessions round the
> times when patients roll up fastest. I can see inequities around this, but
> the fact remains,  we have to change our working practices somehow,  and
> plainly the present system just does not seem to work.
> I hear the London Hospital has just ended a trial period of doctor initial
> assessment,  seemed to be guardedly optimistic about it.
>
> Likewise,  guardedly optimistic,
>
> Paul Ransom
>
>
>
>
>
> ----- Original Message -----
> From: Cliff Reid <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, March 17, 2002 5:31 PM
> Subject: Re: Reforming emergency care
>
>
> > AUGUST 2000, Acad-ae-med:
> >
> > "Currently in our departments, as you know, the best consistent level of
> > patient care offered is that provided by the least competent SHO (or
maybe
> > nurse practitioner). Increasingly I believe this will not be tolerated,
> and
> > with due respect to these SHOs (or Nurses) nor should it be"
> >
> > Tony Good
> > Consultant A&E
> > Liverpool
> >
> >
> > "The public are not stupid and will demand this of the politicians and
> > providers"
> >
> > John Chambers
> >
> >
> > MARCH 2002, Dept of Health Streaming document:
> >
> > "All accident and emergency departments have resuscitation facilities in
> > place. Plans should be in place by March 2002 to develop a system that
> > ensures a person of appropriate seniority assesses patients in triage
> > categories 1& 2."
> >
> >
> > Wanna tell me some lottery numbers, chaps?
> >
> >
> >
> >
> > Cliff Reid
> > Registrar in paediatric critical care
> > Australia
> >
> > _________________________________________________________________
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> >
>