We run a similiar intiative in SVUH. Each patient is seen after triage in
the RAT( rapid assessment treatment) room by either a consultant or SpR. A
decision is made whether the patient can go staright home, needs immediate
treatment in zone 1or 2 or by clinical fellows or SHOs or can be fast
tracked to an investigation eg- CT or U/S and then to our CDU.Pleases
patients as they're seen within minutes by a senior doctor and certainly
ensures a quicker more effective flow of patients. Also provides teaching
for SHOs.
Had my intiatial doubts that it would turn SpRs into triage nurses but have
to admit that it works well for patients and the dept.
Regards,
Jean O'Sullivan
SpR St. Vincent's University Hospital, Dublin
>From: Rowley Cottingham <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List
<[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: Multiple clerkings
>Date: Fri, 29 Apr 2005 20:47:52 +0100
>
>The answer is not to clerk in the ED. We have pioneered the PAT
approach;
>the primary assessment team. The idea behind this is that the patient is
>assessed by a senior doctor and nurse. The paperwork looks nothing like
a
>clerking - deliberately. We do enough to make a decision - obvious
admission
>(fine, resuscitate, off to medical assessment unit as soon as safe) or
needs
>bloods to decide. This second group are passed to an SHO to clerk and
>probably go to the CDU to await results. The SHO can then update the
senior
>doctor with the full clerking to facilitate decision making. The target
time
>for PAT is 7 minutes, and it happens at entry. Currently we run this
from
>8am to 9pm. Works for us, although there are certainly other approaches
that
>achieve the same end.
>
>I'll happily forward a copy of the latest version of the template to
anyone
>interested rather than clogging up the list.
>
>Best wishes
>
>
>Rowley.
>
>
>
>-----Original Message-----
>From: Accident and Emergency Academic List
>[mailto:[log in to unmask]] On Behalf Of Sunil Dasan
>Sent: 29 April 2005 11:21
>To: [log in to unmask]
>Subject: Multiple clerkings
>
>
>Does anyone on the list know of any documentation which is used for all
>emergency attendees (ED and other emergency units) and then carried on
by
>inpatient teams if they are admitted?
>
>We are having a bit of a problem with patients having the same histories
>documented time and time again by nurses, A&E docs and inpatient
docs
>amongst others.
>
>I'm happy to be contacted off-list
>
>Sunil
>
>
>http://www.surreyandsussex.nhs.uk
>
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