----- Original Message -----
From: "Fred Cartwright"
Subject: Re: See and Treat[Scanned]
--- John PASKINS wrote:
> > I think it is a pity that the DoH does not understand
> > the difference between speed and quality,
> > (the 4 hr target is Ok but it is not really the point is
> > it?)
> It is as far as the patients are concerned. They don't
> really want to wait 6-8 hours with a broken wrist even
> if they have had some analgesia and a sling from the
> triage nurse.
As quality is so difficult to gauge in minors, the government are turning to
waiting times for want of a better "proxy". They've done it with just about
every other aspect of medical practice, so we've just gotta accept it unless
we think of something better. But personally, I think an "assault" on
waiting times will make our departments much pleasanter places to work in,
and other measures of quality will surely improve as a result.
> > I think it is a pity that after all the work
> > that was done to get triage
> > up and running it has now been decided that we don't
> > need it any more, but
> > sulking is not the way to deal with them.
> Well I don't see how you can seperate patients into
> streams without doing some sort of triage/assessment.
> Even more important when the outcome of that
> assessment could be "Go away you don't need to be seen
A very good point, Fred, I still can't figure out how some people believe
triage has had its day. But I haven't been to my "see and treat" day yet,
maybe I'll see the light!
> > Trolleys in this door.
> > Walking wounded through that one.
John, do you still work in an A&E department? I don't mean that to sound
cheeky, as maybe you don't, and I can't recall your background right now.
But the system you describe used to work well for us in the 1980s, so you do
have a point. If only we could turn our attendance figures and patient
expectations and management strategies back 20 years, it just might work.