Emergency Department Overview Tatiana Acosta Thayse Darzi Esperanza Muino
General Definition Emergency Department (ED) is a section of an health institution that is staffed and equipped to provide rapid and varied emergency care, especially for those who are stricken with sudden and acute illness or who are the victims of severe trauma. The emergency department may use a triage system of screening and classifying patients to determine priority needs for the most efficient use of available personnel and equipment.
Triage System It’s the process by which patients are classified according to the type and urgency of their conditions to get the: Right patient to the • Right place at • Right time with the • Right care provider • Triage Levels Resuscitation • Emergent • urgent • less urgent • Non urgent •
General Related Facilities/Services Mild fever, cold or flu Heart attack Sprains or strains Trauma Minor allergic reaction Cardiac arrest Ear or sinus pain Chest pains Nausea, vomiting or diarrhea Numbness in face, arm or leg Rashes Difficulty speaking Sore throat Severe shortness of breath Minor cuts Symptoms of a stroke Painful urination Deep cuts Heat stroke and dehydration Infants under 12 weeks old with a fever Urinary infections Head or eye injuries Minor burns Severely broken bones or dislocated joints Cough Severe flu or cold symptoms Dizziness Severe abdominal pain Headache Serious burns Pink eye Blurriness of vision Mild stomach pain Vaginal bleeding with pregnancy Severe asthma attack poisoning
Common Emergency Department Patient Flow Chart
General Characteristics & Equipment An ED requires different equipment and different approaches than most other hospital divisions. Patients frequently arrive with unstable conditions , and so must be treated quickly . They may be unconscious, and information such as their medical history, allergies, and blood type may be unavailable . ED staff are trained to work quickly and effectively even with minimal information. Because time is such an essential factor in emergency treatment, EDs typically have: Their own diagnostic equipment to avoid waiting for equipment • installed elsewhere in the hospital. Nearly all have radiographic examination rooms staffed by • dedicated radiographers. Many now have full radiology facilities including CT scanners and • ultrasonography equipment. Laboratory services may be handled on a priority basis by the • hospital lab, or the ED may have its own "STAT Lab" for basic labs (blood counts, blood typing, toxicology screens, etc.) that must be returned very rapidly.
Care Providers Physicians & Nurses Background & Education Emergency medicine physicians make immediate treatment decisions about a patient of any age or gender who is experiencing a medical emergency, they follow stabilization, and admits the patient to the hospital or discharges the patient from the emergency room with a referral to an appropriate physician for follow up. They do not work out of medical offices, see patients by appointment, or follow patients with chronic conditions, they usually work on a determined schedule, allowing them more control over their personal lives. Emergency medicine physicians must have a graduation from an accredited medical school and obtain license to practice as a medical doctor, after they perform a residency in emergency medicine. These are either 3 year or 4 year residencies, and the physician must pass both written and oral exams to be board certified. A re-certification is required every 10 years through the Maintenance of Certification (MOC) program. Subspecialty certification varies depending on the subspecialty chosen, it can be a year (such as sports medicine) or more. Emergency medicine physicians can be certified as: Emergency Medical Services Hospice and Palliative Medicine Internal Medicine – Critical Care Medicine Medical Toxicology Sports Medicine Undersea and Hyperbaric Medicine
Care Providers Physicians & Nurses Background & Education Emergency Nurses need to continually prioritize patient care and provide ongoing assessment and treatment of a diverse patient population with varying degrees of illness in an uncontrolled, unpredictable environment with an indefinite workload (Emergency Nurses Association (USA), 1988; Curry, 1994). Nurses diploma can be a 3 year or a 4 year program degree, and to become an emergency nurse takes an extra time-period and certificate. Emergency Nurses specialization varies according the facilities and services.
General Design Guidelines Emergency Department Staff requirements: Emergency medicine requires relatively high levels of staffing multi-disciplinary team, working on a 24/7 basis. safe, ergonomically efficient work environment The ED must provide a suitable environment. Ambulance Staff who may attend with patients. Heightened emphasis on improving patient outcomes Use of Lean concepts to optimize operational efficiencies. Super-flexibility for quick expansion. integration of technology. Accessible to the community. preparation for catastrophic incidents.
Case study 20900 Biscayne Blvd | Aventura, FL 33180
Aventura, FL Population/Demographics RELIGION OVERVIEW 39.76% of the people in Aventura, Florida are religious, meaning they affiliate with a religion. 21.99% are Catholic 0.60% are LDS 5.66% are another Christian faith 1.13% in Aventura, Florida are Jewish 0.18% are an eastern faith 0.92% affiliates with Islam.
Emergency Department Patient Flow Chart
Related Facilities/Services Common Medical Emergencies fever of 102 degrees or higher in children or 103 degrees • for adults. Broken bones or serious sprains that affect mobility • burns that is larger than the size of your hand • Large or deep wounds, that bleed heavily • Severe allergies or asthma attack • Heart attack or stroke symptoms, including chest pain, • dizziness, fainting, slurred speech, confusion, and partial paralysis or muscle weakness. Diagnostic services, such as a physical exam, blood • tests, and diagnostic imaging. Illnesses may be treated with medication such as • intravenous fluids to prevent dehydration. In cases of severe illness, onsite monitoring may be • required. Wound care and trauma • An orthopedics specialist may treat broken bones • surgery is needed, it may be scheduled immediately •
Design Guidelines Wayfinding Signage system, terminology, and lighting may afford clarity of information/directions/location. • Reception areas are major elements in this project. • Privacy and Personal Territory Visual and acoustic privacy and control are issues that will need to be considered in relation to • the patient care room environment. Room configuration, adjacencies, materials and finishes are important factors. • Areas associated with financial matters will require privacy as well. • Safety & Security Surveillance and control issues are important Psychologically. • Line of sight and acoustic issues are always a concern. • Complete view of reception areas from the receptionist is important. • Storage of personnel items of the employees as well as the patients will • need to be considered.
Design Guidelines Cont. Comfort Activity requirements • Flexibility in : light, views & furnishing • Materials/Finishes Color, textures, static electricity, durability, maintenance and psychological considerations. • Theory of integration Uses of theories related to patient care • Art Program Development of an art program that would be appropriated for this care environment • The art program for healthcare environments is especially important as it may affect user’s • productivity and psychological comfort.
Questions for interview with Architects and the Hospital For the Staff What are the major problems of working in an emergency department? • How you classify the emergencies? • How do you think we can reduce patient’s waiting time? • How is the process of maintenance/ cleaning? • What is the maximum capacity of people at the ED? • Do you have Privacy issues? How do you address them? • For the Architect What state regulations have made it difficult for the design of the facility? • How do you define territories of both the patient and the staff without blocking or creating barriers? • Explain storage requirements • Does this facility incorporate sustainable features and practices? • What was the concept or inspiration for the interior design of this facility? • In general do you consider the furniture used in healthcare facilities appropriate for patients, • doctors and staff?
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