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Emergency Department Adult Observation Chart Changes

January 18, 2021

Overview :

The Emergency Department Adult Observation Chart has undergone some changes including:

  • Update to management of valuables in line with WH policy and procedure
  • Amendments to the BOC chart including, frequency, S = sleeping, W = worried and additional management matrix strategies
  • Update to the Risk Screening tools to improve quality and safety and to better align with the National Safety and Quality Health Service (NSQHS) Standards

Alignment to Western Health Best Care Framework:

Right Care  & Safe Care

Why is this important:

Documentation is an essential component of effective communication. Given the complexity of health care and the fluidity of clinical teams, healthcare records are one of the most important information sources available to clinicians. Undocumented or poorly documented information relies on memory and is less likely to be communicated and retained. This can lead to a loss of information, which can result in misdiagnosis and harm.

What does this look like in practice:

Figure 1: Valuables and Risk Screening Tool changes:

Key changes:

  1. Ability to document that someone has taken responsibility for  own valuables.
  2. Documentation of valuables entered into safe due to patient unable to understand or consent to securing own belongings
  3. Documentation of valuables entered into safe at request of patient or next of kin.
Figure 2: Risk Screening Changes:

We have added screening questions, and associated actions for delirium, mental health, and end of life care. The questions for Alcohol and Other Drug screening have also changed.

We have changed the name of IRS to ACE.

Associated Documents:

QRG – Risk Screening in the Emergency Departments

QRG – Management of Patient Valuables