Patients appropriate to wait in waiting room prior to discharge

This document provides a summary of best practice in relation to the selection of appropriate patient cohorts that can safely wait in the ED waiting rooms prior to discharge. The summary has been created to support staff during the Sunshine Hospital Emergency Department Redevelopment transition and early post-move period, and has been endorsed by the ED Leadership Team.

Overview:

WH assesses and treats approximately 130,000 patients per annum and access to clinical treatment areas for the delivery of clinical care can at time be challenging.

This QRG aims to provide guidance in the selection of appropriate patient cohorts (both Children and Adult) that can safely wait in the ED waiting rooms after clinical assessment and/or treatment prior to discharge to assist with access and flow to clinical spaces.

Applicability:

This QRG applies to all Western Health EDs and provides a framework to enable consistency and standardisation of Access and Flow issues in an effort to access clinical spaces in a timely manner.

This QRG does not apply to those patients who are in the waiting room, waiting for a treatment cubicle, and who are transiently moved to a triage assessment room for a clinical assessment.

Responsibility:

It is the responsibility of the ED NUM’s and Medical Directors to ensure all relevant staff are appropriately orientated and educated to the content of this QRG and their respective responsibilities.

Guideline/Process Details

Key points:

Inclusion/Exclusion criteria

INCLUSION CRITERIA		EXCLUSION CRITERIA
ADULT	CHILDREN	ADULT	CHILDREN
Waiting for letter	Waiting for letter	Confused patient or Patients unable to independently mobilise	Unaccompanied children
Waiting for script	Waiting for script	BOC ≥ 1	BOC ≥ 1
Waiting for private transport home including Taxi	Waiting for private transport home including taxi	Patient with observation outside those deemed appropriate for that patient by treating MO	Patient with observation outside those deemed appropriate for that patient by treating MO
Waiting for an investigation result to confirm safe discharge	Waiting for an investigation result to confirm safe discharge	Patients undergoing active Emergency Department treatment i.e. IV fluids	Patients undergoing active Emergency Department treatment i.e. IV fluids

ED Consultants/Registrars I/C are to review and liaise with ANUM/NIC patients that are appropriate to be discharged to the waiting room pending discharge.
Departmental cubicle occupancy should be considered in the decision to place a patient and their family back into the waiting room. If there is capacity for them to wait within a cubicle then this would be preferred.

Supporting Documents

Document Governance

Title:	Patients appropriate to wait in waiting room prior to discharge
Version:	1.0
Date Published:	01/06/2021
Date of scheduled review	01/02/2022
Author:		Approver:
SHED Leadership Team		SHED Leadership Team

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