Dealing with Emergency Department demand
Dr Ruth Large & Angela Alvarado
ED DEMAND - The size of the problem
• Over the past 3 years there has been an incremental
rise in National Emergency Department presentations
from 218,000 to 238,000 presentations.
• In Thames Emergency Department we see
approximately 1000 more presentations every year.
Trend of National Performance &
ED DEMAND – Trendof National Performance and Presentations Presentations
Number of Presentations
ED DEMAND – Future demand
But we face an even more significant
Statistics New Zealand, March 2006
ED DEMAND – Putting
the demand into context
• We do not see large increases in patients being
admitted into hospital.
• Emergency Department visits are costly and do not
deliver good value for money for many of our
• Emergency Department patients are more likely to
have unnecessary investigations.
• Emergency Medicine is NOT rocket science
ED DEMAND – Why the Increase in ED Load?
The public have lost the ability to correctly self triage.
There is scare-mongering in the media.
The medical fraternity has encouraged reliance.
Many of the public have the misconception that the
hospital provides the best quality health care.
• General Practice is overwhelmed
The worried well:
• An increasing number of patients self-triage to the ED with
symptoms that are not an emergency.
• We need a safe and efficient way to deal with this increasing
load to reduce the risk of overwhelming the system and to
enable the ED to perform their core business.
ED DEMAND – The potential Solution
• An automated system which utilises red
flags from the history and vital signs
could enable patients to effectively triage
themselves on presentation.
• Ideally this system would be integrated
with a GP booking service and the
presentation would be visible to the GP.
• The patient would receive clear guidance
as to self-management
HEALTH KIOSK – Screening patients to the correct care provider
HEALTH KIOSK – Features
Blood O2 Saturation
Temperature (IR non contact)
Biometric Finger reader
Phone over internet
Multi - Language Options
Health Kiosk – Patient History Module
documenting their own
history at the kiosk
Patients can move quickly
through the dynamic
questionnaires from an
Answers are converted
into clinical terminology
and organized by organ
Health Kiosk – Patient Symptoms Module
A few of the questions for
Lower Back Pain
• Have you injured your back in the
past 2 days?
• Do you have new loss of feeling in
your groin or legs?
• Do you have back pain that
travels down your legs?
• Have you developed difficulty
• Are you unable to control your
• Do you have new muscle
weakness in both legs?
Enabling Patient Self Management
Patients are provided with
information, pictures and
home care instructions based
on their symptoms.
• Information can be printed.
• Appointment can be made
with their GP
• They can email their visit
report to their GP.
The Health Kiosk will enable
patients to be co-producers in
the management of their own
Health Kiosk – Best Care Option
Where to go for Care?
Best Options for Care
Based on your responses,
It is recommend you see
Your doctor within 3 days
Use the button below to make
an appointment with your GP