Do not compromise the care for sicker ones by filling beds with the stable patients who are waiting for an inpatient bed allotment. Not fair..
- Involve your specialty colleagues early if you have a good sense of what is happening. For instance, don’t wait for the white cell count for appendicitis before you call a surgical consult. If you think it is appendicitis, get them to see the patient ASAP. White cell count is an overrated crappy lab. You cannot rule out appendicitis/sepsis with a normal white cell count.
- When the ED is packed, speak to the attending/consultants directly because they are the ones who are going to make a decision. Do not linger around with a resident who has joined the service last week. Click here to read more on how to ask for a consult.
Things that actually matter the most to patients:
- Empathy/attitude (They don't judge you by the quality of medical care that you provide)
- Timeliness of care
- Technical competence of care providers
- Pain management
- Information dispensation
Other things that you may try out:
- Physician at Triage: Expedites care and almost one third can be can be rapidly discharged
- Virtual wait rooms: Still in the conceptual stage. For non-urgent patient, paramedics contact the hospital to schedule a visit. The patient gets added to the ED queue without having to be there in person and could wait at home. As the scheduled time approaches, the patient comes to the ED.
- Have a dedicated transport staff
- Have a dedicated person to manage financial issues (major problem in India) and arranging in patient beds.
- Point of care testing
- Campbell SG, Sinclair DE. Strategies for managing a busy emergency department. CJEM. 2004 Jul;6(4):271-6