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Emergency

Mike Pitura, CRN in emergency at Concordia Hospital

We asked Mike Pitura to provide some suggestions and ideas to inspire nurses who work in emergency about how they can help facilitate improved patient flow. Here are his thoughts:

Rapid Assessment Zone

The Concordia Hospital toured a couple of other facilities in the country approximately one year ago. Their experience inspired the introduction of a Rapid Assessment Zone (RAZ) at Concordia Hospital.

The introduction of a rapid assessment zone - a specific area within the emergency department - allows nurse observation without occupying a bed. People who are assessed as CTAS (Canadian E.D. Triage and Acuity Scale) level 3 or 4 don't always require a bed.

It opens up space in the main department for people who need to lie down. If you are ambulatory, your vitals are stable, and you don't need a private room. You don't need to occupy a stretcher to get quality care.

The RAZ allows the ED a flex area to alleviate the pressure on the waiting room attempting to decrease wait times. Since July of 2013, we have tried to implement RAZ during specific times throughout the day; and sometimes depending on the patients' in the ED, and resources that are available, patient flow can improve significantly. This is a team sport in better servicing the patient's we provide care to.

With the RAZ, we have more flexibility to see a higher volume of patients with smaller physical space.

On communication

So, when asked how I think nurses can empower themselves to improve flow within their departments I would say that information is empowering. I would stress the importance of effectively communicating that information within the health care team. By ensuring that information is effectively communicated amongst team members a unified approach to care can be achieved resulting in improved patient flow.

I strongly encourage other facilities to adopt ways to improve communication on a shift to shift basis; I feel we have achieved this at Concordia Hospital with our adoption of the flow huddles.