I decided to try this the other day and see every major that came through
the department, organise a treatment plan and set the SHOs running
(ambitious I know but it was my seven day challenge from the ESC meeting!).
I thought that this might improve care and reduce patient times. When I
briefed the SHOs the day before they were most upset, as they felt I was
taking away their learning experience by denying them the need to make
decisions! This was especially true of a couple who are thinking of doing
A&E. As a compromise I 'encouraged' a focused history and examination and
reviewed all patients/plans prior to investigation. This worked pretty well
on the day. My feeling was that in all but a few cases there was little
time saved but there was hopefully a quality control/improvement on the
majors side. The SHOs were also happy as they felt the day had been more
educational for them. The biggest benefit, however, just seemed to be
gained from having a more experienced person on the shop floor seeing
patients. It is hard to get away from this basic fact in all the
improvements that seem to be tried in various departments. Throwing
experienced staff at a problem works both for quality and quantity!
Simon McCormick
Locum Consultant Doncaster A&E
P.S. It was heartening to hear the SHOs interested in A&E still showing
some interest in 'minors' and not just wanting to see majors all day.
Unfortunately, by the time they qualify the specialty may have changed
beyond recognition (or disappeared completely!). My guess, I thing Rocky is
right, there will be A&E people around for a long time to come. We are the
experts in all types of emergency care and are some of the last true
generalists left. Just watch some of the so called specialist struggle in
resus, majors or minors!
----- Original Message -----
From: Cliff Reid <[log in to unmask]>
To: <[log in to unmask]>
Sent: 15 December 2002 14:24
Subject: Re: trick or treat
> Does see and treat apply to all-comers or just to minors? Surely majors
> patients would benefit from a senior eyeball on arrival so that an
> investigation/management plan can be initiated?
>
> Cliff Reid
>
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