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Clinicians' Challenge - Dealing With Emergency Department Demand
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  • 1. Clinicians Challenge Dealing with Emergency Department demand Presented By Dr Ruth Large & Angela Alvarado
  • 2. 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.
  • 3. Trend of National Performance & ED DEMAND – Trendof National Performance and Presentations Presentations 100% 245,000 95% 240,000 235,000 90% 230,000 225,000 85% 220,000 80% Performance Presentations 250,000 215,000 210,000 75% 205,000 200,000 70% 1 2 3 4 5 6 7 8 Number of Presentations 9 10 11 Performance 12 13 14 15 16
  • 4. ED DEMAND – Future demand But we face an even more significant challenge Statistics New Zealand, March 2006
  • 5. 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 patients. • Emergency Department patients are more likely to have unnecessary investigations. • Emergency Medicine is NOT rocket science
  • 6. ED DEMAND – Why the Increase in ED Load? My postulation: • • • • 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.
  • 7. 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
  • 8. HEALTH KIOSK – Screening patients to the correct care provider BIOMETRICS HISTORY SYMPTOMS ED GP HOME
  • 9. HEALTH KIOSK – Features BIOMETRIC MEASUREMENTS • • • • • • • Height Weight BMI Blood Pressure Heart Rate Blood O2 Saturation Temperature (IR non contact) ADDITIONAL FEATURES • • • • Biometric Finger reader Phone over internet Multi - Language Options A4 printer
  • 10. Health Kiosk – Patient History Module • Patients begin documenting their own history at the kiosk • Patients can move quickly through the dynamic questionnaires from an extensive knowledgebase • Answers are converted into clinical terminology and organized by organ system.
  • 11. 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 walking? • Are you unable to control your bladder? • Do you have new muscle weakness in both legs?
  • 12. 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.
  • 13. Health Kiosk – Best Care Option Where to go for Care? Best Options for Care Recommended 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 BOOK APPOINTMENT Tāpuia whakaritenga Your GP Recommended Home Care Not recommended Emergency Department
  • 14. Health Kiosk – Sharing Information