Amy is a fourth year emergency medicine resident, who has recently started supervising medical students while on shift. She meets Jim, a third year medical student, who will be working with her for the shift. Over the course of the shift, it becomes apparent that Jim is struggling with understanding a charge nurse’s role in the emergency department. Amy wishes there was a way for medical students like Jim to gain more insight …
HiQuiPs: Preparation Part 3 – Root Cause Analysis
You have just finished a monthly business meeting with your emergency department (ED) team. One of your colleagues highlighted a recurring issue of the length of time it takes from ordering blood products to administering them in your ED. There is often a long delay in administration for patients who are in acute need. You have gathered a team to start working on this quality improvement project. The team has put a …
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 …
HiQuiPs: Preparation Part 2 – Stakeholder Engagement and Behavior Change
You have recently finished a review of incidents that have been flagged in your ED. You have chosen a pertinent issue to tackle, formed a core group to work on the project, and formulated a SMART aim statement after reading our last HiQuiPs post. The median time for obtaining 12-lead ECGs is 13 minutes, while guidelines recommend less than 10 minutes.1 Your aim is to decrease the initial 12-lead ECG acquisition time by …
CAEP FEI | Human Trafficking Awareness: A Learning Module
Jeremy is a second year resident who is about to see a 25 year old female presenting with abdominal pain. During the history he notices the patient is remarkably quiet and that the patient’s male friend is answering all the questions for her. When Jeremy asks the male friend to leave the room for a moment, both the patient and the friend object. Jeremy starts wondering if this patient might be a victim …
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 …