You are working in the Emergency Department on a day when it is busy and bed blocked. You assess a patient presenting with chest pain in the EMS offload area. Standing next to the stretcher, stopping to move every time a porter comes by with another patient stretcher, you sense that your patient is frustrated. After the initial workup is complete, you go to reassess your patient and review the results. As you …
HiQuiPs: Patient Safety in the ED Part 4 – Patient Handovers and Transitions of Care
You are beginning a morning shift in the Emergency Department when the overnight physician comes up to you and asks “Hey, can I give you a few handovers?” Your colleague provides a brief verbal handover for three patients and then says “this fourth one is a slam dunk admit, I’ve called the hospitalist and they’ll come to see the patient sometime this morning. Don’t even worry about it.” A few hours later, a …
FLOW Hacks 8 – In & out of the ED for the ‘Treat & Release’ patient.
To continue our FLOW Hacks series, Victoria Woolner (NP, MN, MSc QIPS) writes about her team’s project tackling the ‘Treat and Release‘ patient. Setting This intervention was carried out at Toronto General and Toronto Western Hospital (UHN) in Toronto, Ontario. Between the two sites, there are approximately 117, 000 visits per year. Description of the innovation Treat & release (T&R) patients are patients that have been seen in the ED and asked to return …
FLOW Hacks 7 – Doc in the Box: Improving Physician Initial Assessment Time in the Emergency Department
To continue our FLOW Hacks series, Dr. Joanna Bostwick writes about her team’s innovation aimed at improving physician initial assessment time in the ED. Setting This intervention was carried out at Hôpital Montfort, Ottawa, Ontario, an academic francophone community hospital with 56, 000 ED visits per year. Description of the innovation Our ED has applied an adapted version of Physician in Triage (PIT) termed “Doc in the Box” with the goal of decreasing physician …
FLOW Hacks 6 – Improving Usage of Probenecid for Skin and Soft Tissue Infections
To continue our FLOW Hacks series, Dr. Shawn Dowling writes about his team’s innovation aimed at reducing the number of Emergency Department (ED) revisits for repeated IV antibiotic administration. Setting This intervention was carried out in all of the EDs in Calgary, Alberta. Across all four sites, there is an average of 320, 000 patient visits annually. Description of the innovation In order to reduce the number of revisits to the ED for …
HiQuiPs: Preparation Part 1 – General Considerations for ED Quality Improvement Projects
You are in the middle of a busy night shift and you see a 73-year-old female with diffuse abdominal pain who is hemodynamically stable. You have a wide differential and order a CT scan to aid in the diagnosis as you begin empiric management. Three hours pass by and the CT has not been performed. This is the third time this week that this has happened. In light of this, you feel strongly …
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