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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 DISCLAIMER: Unless expressly stated otherwise, the information contained in this e-mail is confidential and is intended only for the named recipient(s). If you are not the intended recipient you must not copy, distribute, or take any action or reliance upon it. If you have received this e-mail in error, please notify the sender. Any unauthorised disclosure of the information contained in this e-mail is strictly prohibited.