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ACAD-AE-MED  February 2003

ACAD-AE-MED February 2003

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Subject:

Re: Restricting access to A/E departments.[Scanned]

From:

"Plunkett, Patrick (Emergency Medicine)" <[log in to unmask]>

Reply-To:

Accident and Emergency Academic List <[log in to unmask]>

Date:

Tue, 11 Feb 2003 14:32:48 -0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (143 lines)

Martyn
All others come to reception and are allowed through the ambulance door by
the security personnel.  This, once again, has not been a problem (other
than some VAS personnel feeling a bit miffed initially - our personal and
professional links with SJA are such that this issue has quietly gone away!)

Privates do not transport emergencies to us - other than the local
Industrial Complex (Guinness) who have a swipe card.

As far as I am concerned Triage is a twin tool - one to identify those who
need immediate care, and give it immediately - reception and security staff
have a role in ensuring that anyone a lay person feels looks very ill is
notified to Triage immediately.  The other is to ration care whilst
providing an amusement to fill in the waiting period.

Trick or Treat is, in my view an excellent mechanism to promote burnout in
senior people.  Unless adequate resource is provided to ensure short runs at
T&T, interspersed with rest periods/ admin/ major cases, to allow a decent
working shift, I would not be prepared to implement it.

But then again - I work in a different jurisdiction!  Here, we measure the
passage of time with calendars (n'est pas, mes braves?) - at least for
admitted patients awaiting transfer to wards.

Patrick

-----Original Message-----
From: Martyn HODSON [mailto:[log in to unmask]]
Sent: 11 February 2003 14:19
To: [log in to unmask]
Subject: Re: Restricting access to A/E departments.[Scanned]


----- Original Message -----
From: "Plunkett, Patrick (Emergency Medicine)" <[log in to unmask]>
To: "Martyn Hodson" <[log in to unmask]>
Sent: Tuesday, February 11, 2003 1:58 PM
Subject: Re: Restricting access to A/E departments.[Scanned]


> We lock our doors 24/7.  We also lock the doors at the rear of the
> department - into the main hospital - at night.  This is a security issue
> for staff.
>
> The patients arriving by ambulance access the department through (locked)
> ambulance doors as the ambulance crews have swipe cards attached to the
> ambulance keys (also persuades them to switch off the engines and stop the
> fumes). They must also swipe out through these doors.  This prevents the
> bright boyos in the neighbourhood simply walking in and out these doors
and
> going thieving in the ED or the hospital! This has beeen in place almost
12
> months now, with no clinical difficulties so far.

what about the VASes do they have swipe cards on their Ambulance key rings ,
and what about neighbouring statutory services? Private providers? how do
these legitmate sers of the ambulance entrance gain access?

the alternative is to devise a layout where there is acommon entrance for
both walkin and Stretcher patients - we have this at Scunthorpe

>
> Those arriving by other transportation can access the waiting room, but
not
> the main body of the department, unless allowed in by a staff member.
This
> latter block has been in place for 3 - 4 years, again with no clinical
> difficulties.

but they can access the waiting room and be seen by a member of staff evne
if it is 'only' the receptionist - who if approrpaite trained should be able
to identify those who walkin in but require immediate assessment  rather
than waiting their turn for triage or to be 'trick or treated'

> We have 24 hour Reception and Security staff, and the Triage Nurse has a
> Monitor showing the camera view of the Waiting Room.  We do not use it as
a
> tool to restrict patient access to Emergency Services - merely as a tool
to
> enhance staff and patient safety.

this is the correct attitude towars locking doors within the dept IMO,
rather than what appears has bene suggested by the PCT in question of
locking the entrances and the poor punter having to beg for admittance - one
patien adverse icndet nad the phrase 'a whole new world of Poo' wouldn't
even come close  - it only takes one asthmatic or chest pain to collapse ,
or a partially sighted person  or deaf prson to fail to gain entry becasue
of the system fir it all to come crashing down and it will will crash down
on the hospital not the PCT, becasue  ( a combination of cynicism and
sarcasm in a porr attmept to copy HIGNFY or Private eye) don't forget PCTs
are full of jolly GPs and smileing DIstrict nurses , community midwives and
HVs rather than the arrogant surgeons , suercillous Physicans and uncaring
Nurses that hospitals are
>
> It takes people a little while to get used to carrying their swipe cards.
> Since we made access to the staff changing rooms and loos swipe-card
access
> only, our compliance rate with wearing ID badges (which have the
> swipe-stripe) has increased markedly!

LOL
>
> Staff members not on the ED staff list can only swipe through the doors at
> the rear of the dpartment.  If they arrive at the front door, they have to
> be allowed though by reception or security.  This has also had an impact
on
> our through-traffic, though not as much as I would like, as there is a
> rear-corridor which allows access to another building - but our
> refurbishment will block this off also.

through traffic is a problem espoecially iwth the layout of some depts

Martyn Hodson
[log in to unmask]
Registered Nurse
SJA Ambulance Attendant
writing for myself, views expressed are entirely my own,
and may not reflect those of my employer or St. John Ambulance , Nationally
or locally
-Duct tape is like the force, it has a light side and a dark side,
and it holds the universe together.




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