--- [log in to unmask] wrote:
> There are a number of things that are not so clear
> to me about "see and
> treat":
I think a lot of us are confused. I can only give a
personal view of what I think it is!
>
> 1. Who decides (and how) whether a patient should be
> seen in minors or
> majors?
Triage operates as before. Everyone gets allocated to
streams, self care, Primary care, minor
injuries/ailments etc. When see & treat is operating
you essentially split minor injuries/ailments into see
& treat and standard minors queues.
>
> 2. If the staff is still the same and the
> attendances are not reduced, why
> should "see and treat" reduce significantly the
> waiting time?
Ah! Now there is the rub! That is my major criticism
of See & Treat trials. There was a paper at the
Edinburgh conference from St.Thomas' and my criticism
of that was the consultant and senior nurse doing the
see & treat were extra to the normal complement. My
arguement was that they would have reduced waiting
times where ever they had been in the department.
>
> 3. How will you be able to have the full picture of
> the state of the
> Department at any one time, if you do not know what
> is wrong with the
> patients who are still waiting to be seen and
> treated, and will not be
> triaged?
The idea is that there won't be much of a queue. As
they are seen and dealt with quickly a queue won't
form.
>
> 4. If you need a senior doctor to see and treat
> patients, who will see the
> critically ill patients, (particularly out of hours
> - i.e. nights).
Again another problem You need 2 senior docs.
>
> 5. What will the nurses in minors do? (Will there be
> any nurse in minors?)
Well there is still a lot of work that isn't suitable
for see and treat. they will go into the standard
minors queue. Things that will take more than 5-10
minutes go into this.
>
> 6. What will the SHOs do?
See the rest. I suppose they will also have to sit in
on see & treat as part of their training.
>
> 7. Is there any evidence that triage and division of
> roles (one triages,
> one sees and one treats) is the major responsible
> for the lengthy waiting
> time? Have other possible causes been excluded?
The causes of long waits is multifactorial. Delays
between being seen and treated is one of them. See &
treat is essentially ring fencing someone for minor
treatments.
Cheers Fred.
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