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Informing clinical policy for ED waiting room management to reduce the incidence of ‘left before treatment’
208 nications enhancement workshops were attended by over 2000 Emergency Department staff. The communication tools have been adopted nationally and internationally. Participant evaluations and follow up interviews with Emergency Department managers were positive and provided constructive feedback. Factors critical to the success of this initiative are discussed and provide learnings to inform future strategies to enhance patient experiences and patient centered care. doi:10.1016/j.aenj.2008.09.037 Informing clinical policy for ED waiting room management to reduce the incidence of ‘left before treatment’ Diana Lopez ∗ , Bernice Redley This paper reports on findings of a project to describe the strategies currently used in Victorian Emergency Departments to monitor, follow up and minimise the number of patients who leave the Emergency Department (ED) without receiving or completing treatment. Patients who leave the Emergency Department before receiving treatment are an important quality marker of accessibility to health care, quality of service delivery and the functioning of emergency health care systems. Data suggests the percentage of patient who not wait for treatment at most Victorian health service Emergency Departments is about 4%, and this is increasing at some health services. While many of those who leave the Emergency Department without treatment do seek alternative health care, some are at risk of adverse health outcomes. Currently little is known about the activities undertaken by health services to manage this group of health consumers. This knowledge is required to inform policy and service delivery improvement strategies for this group of consumers. Managers in 25 metropolitan, regional and rural hospital Emergency Departments participated in a survey. This was complemented by visits to selected health service. The findings provide examples of innovation and good practices to respond to the care needs of those at risk of leaving before receiving or completing treatment, minimise clinical risk and manage, minimise or follow up patients deciding to leave the Emergency Department before they receive or complete their treatment. doi:10.1016/j.aenj.2008.09.038 ‘No one likes to wait’—–Development of a patient information brochure to provide written information to patients at triage Sarah Bullen 1,∗ , Mari Botti 2 1
Emergency Nurse/Research Nurse, Bayside Health, Melbourne, VIC, Australia 2 School of Nursing, Faculty of Health and Behavioural Sciences, Deakin University, Burwood, VIC, Australia The organisation of a busy Emergency Department (ED) is unfamiliar and frightening to patients and their families and the ED encounter is usually brief, impersonal and emo-
Abstracts tionally charged. In this context, patient retention of verbal information may be impaired due to the intrinsic stress and anxiety of the situation, along with the acute injury or illness that has precipitated the ED encounter. This study involved the creation of a written ED patient information brochure, entitled “No one likes to wait”. The brochure was given to patients at Triage to supplement the verbal information supplied by the Triage Nurse, and a short survey was administered to elicit patient-perceived opinion of its readability and usefulness. The ED patient information brochure was conceptualised from the relevant literature and the researcher’s personal experience of triage, in conjunction with the opinions of an expert ED nurse panel. Readability of the proposed text was assessed using the Flesch Reading Ease and Flesh-Kincaid Grade Level Score. Brochure design and layout were based on guidelines sourced from a patient information and education literature review for the production of effective teaching and informational brochures. This paper will focus on the specific steps taken in the development of this ED patient information tool for use in the Australian setting from a research perspective including: • What information was included and why? (Content validity). • How the information was specifically written? (Readability). • How the information was presented? (Brochure layout and design). • And lastly, what did the patients think? (Brochure evaluation via survey). doi:10.1016/j.aenj.2008.09.039 ‘We’re expecting you’: Utilising the Emergency Department Patient Admission Predictive Tool (EDPAPT) M. Jessup 1,∗ , J. Crilly 2 , J. Boyle 3 , J. Lind 2 , G. Green 2 , M. Wallis 1 1
Griffith University, PMB 50, Gold Coast Mail Centre, QLD, Australia 2 Gold Coast Hospital, Southport, QLD, Australia 3 CSIRO E-Health Research Centre, Brisbane, QLD, Australia The majority of acute hospital admissions arise from the Emergency Department (ED). With the current retrospective, reactive bed management approach, a common scenario is a full ED on a Monday morning, the hospital on ambulance bypass by midday, and the last minute cancellation of elective surgery patients. A more appropriate way of reducing access block is to manage inpatient beds prospectively, thereby booking elective surgery on days with lower demand from ED. The EDPAPT project aims to predict patient admissions via two Queensland EDs (Gold Coast and Toowoomba). A tool based on 5 years of ED presentation and admission data, and subsequent mathematical modelling, has been developed to accurately predict the number of acute admissions sourced from ED presentations on any given day of the year. Taking into account peak periods (holidays, special events), it facilitates efficient use of available resources. Implementation and validation of the tool using recent historical data
Emergency Nurse/Research Nurse, Bayside Health, Melbourne, VIC, Australia 2 School of Nursing, Faculty of Health and Behavioural Sciences, Deakin University, Burwood, VIC, Australia The organisation of a busy Emergency Department (ED) is unfamiliar and frightening to patients and their families and the ED encounter is usually brief, impersonal and emo-
Abstracts tionally charged. In this context, patient retention of verbal information may be impaired due to the intrinsic stress and anxiety of the situation, along with the acute injury or illness that has precipitated the ED encounter. This study involved the creation of a written ED patient information brochure, entitled “No one likes to wait”. The brochure was given to patients at Triage to supplement the verbal information supplied by the Triage Nurse, and a short survey was administered to elicit patient-perceived opinion of its readability and usefulness. The ED patient information brochure was conceptualised from the relevant literature and the researcher’s personal experience of triage, in conjunction with the opinions of an expert ED nurse panel. Readability of the proposed text was assessed using the Flesch Reading Ease and Flesh-Kincaid Grade Level Score. Brochure design and layout were based on guidelines sourced from a patient information and education literature review for the production of effective teaching and informational brochures. This paper will focus on the specific steps taken in the development of this ED patient information tool for use in the Australian setting from a research perspective including: • What information was included and why? (Content validity). • How the information was specifically written? (Readability). • How the information was presented? (Brochure layout and design). • And lastly, what did the patients think? (Brochure evaluation via survey). doi:10.1016/j.aenj.2008.09.039 ‘We’re expecting you’: Utilising the Emergency Department Patient Admission Predictive Tool (EDPAPT) M. Jessup 1,∗ , J. Crilly 2 , J. Boyle 3 , J. Lind 2 , G. Green 2 , M. Wallis 1 1
Griffith University, PMB 50, Gold Coast Mail Centre, QLD, Australia 2 Gold Coast Hospital, Southport, QLD, Australia 3 CSIRO E-Health Research Centre, Brisbane, QLD, Australia The majority of acute hospital admissions arise from the Emergency Department (ED). With the current retrospective, reactive bed management approach, a common scenario is a full ED on a Monday morning, the hospital on ambulance bypass by midday, and the last minute cancellation of elective surgery patients. A more appropriate way of reducing access block is to manage inpatient beds prospectively, thereby booking elective surgery on days with lower demand from ED. The EDPAPT project aims to predict patient admissions via two Queensland EDs (Gold Coast and Toowoomba). A tool based on 5 years of ED presentation and admission data, and subsequent mathematical modelling, has been developed to accurately predict the number of acute admissions sourced from ED presentations on any given day of the year. Taking into account peak periods (holidays, special events), it facilitates efficient use of available resources. Implementation and validation of the tool using recent historical data