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At a Glance

Admission/Entry

  • Admit via Emergency Services Arrival or Walk in Triage
  • Transfer from another ED clinical area

Hours of Operation & Length of Stay

  • Open 24/7 – 365 days of the year
  • LOS: < 4hrs

Inclusion Criteria

Inclusion Criteria:

Adult patents requiring:

  • Acute care
  • Frequent observation
  • Specialised intervention
  • Cardiac monitoring
  • Acute psychosocial conditions
  • Infectious patients

Exclusion Criteria:  

  • Paediatric patients
  • Acutely unwell patients in need of high care and resuscitation.

Clinical Care

Core Principles:

  • The Adult Acute cubicles will provide care to adult patients who are acutely unwell, potentially unstable and complex.
  • The management and care of patients within the adult acute cubicles will be divided between two clinical teams of ED clinicians: the green and yellow team or the high risk and low risk COVID teams.
  • Patients arriving by AV will be offloaded into a suitable  cubicle when available and the team allocation will be determined by which teams cubicle the patient is allocated.
  • Stable patents may be offloaded into the waiting rooms and will be assigned to an appropriate team at this point.
  • Teams will be able to filter via the EDIS tracking screen to allow visualisation of all their patients within the ED & wait room.

COVID principles:

  • Patients are streamed to either the high risk COVID (green team) or the low risk COVID (yellow team).

NON COVID principles:

  • Patients are streamed to either the  green or yellow team by metronomic sorting when they self present to the ED.
  • The teams will have one internal wait room and two assessment rooms within their allocated cubicles to improve access and flow through the area.
  • Teams will be able to view on EDIS  the main waiting room patients allocated to their team
  • Adult patients that arrive by ambulance will not be metronomed to a team on arrival. These patients will be offloaded into an available cubicle and team allocation will be determined by which teams cubicle the patient is allocated.
  • The only exception to this is if the patient is directly offloaded into the waiting room.  In this case the patient would metronome to a team.

Emergency Management/Escalation

  • Resus Trolley stored in Adult Acute Cubicle 9

Medical emergency respondees:

  • ED NIC
  • Resus Nurse 1
  • Bedside nurse
  • Resus Registrar

Emergency call equipment:

  • First Responder Trolley – no medications  – located in cubicle 9
  • Bedside emergency roll down equipment in cubicle

Other:

  • Transfer to Resuscitation area as required
  • Code Blue and MET call if additional assistance is required

Staff Safety:

  • Code grey: planned/unplanned
  • Personal duress

Disposition

  • Discharge home
  • Inpatient admission
  • Transfer to another hospital/facility
  • Other ED clinical area or SSU
  • May use the discharge lounge (Non COVID) in hours

Discharge Process:

  • Script
  • Outpatient follow up
  • Certificate
  • Referrals
  • Discharge Letters

Staffing

March, 2022

AM & PM Shifts

Medical staffing:

  • 2 Consultant (Green & Yellow teams)
  • 2 ED registrars
  • 2 SHMO
  • 2 HMO
  • Interns – supernumerary

Nursing:

  • Floor Coordinator
  • ED NIC
  • 8 Nurses  (ratio: 1:3)

ACE:

  • 2 ACE Clinicians

Clerical:

  • 2 Clerks

ND Shift

Medical staffing:

  • 2 X ED registrar
  • 2 x SHMO
  • 2 x HMO

Nursing:

  • Floor Coordinator
  • ED NIC
  • 8 Nurses: Nurse Patient ratio: 1:3

Clerical:

  • 2 Clerks