Waiting to Be Seen: Where EM Policy Meets Practice is a new EM Cases blog series, authored by Dr. Howard Ovens, a veteran Emergency Department Director, whose main purpose is to share ideas and generate discussion on the role that public policy and administrative practices play in creating the conditions that help front line emergency providers achieve better patient outcomes.
It remains to be seen whether influenza and COVID-19 will overlap. The actions we take now will determine how well we navigate the coming waves and resulting surges. We’re aiming for something closer to smooth sailing as opposed to capsizing or, worse, sinking. Dr. Kieran Moore and Dr. Howard Ovens explore preparation strategies for co-circulation of seasonal influenza and COVID-19 in this month's Waiting to Be Seen...
In this month's Waiting to Be Seen blog Dr. Howard Ovens explores The End of The Beginning: What’s Next for EDs in the Pandemic? Many questions have arisen now that we are a few months into the pandemic in North America: How long will ED volumes remain low? What will happen as hospital services ramp up? Will staff get tired of precautions? Will PPE supplies be maintained? What will happen during flu season? What mitigation strategies are available to us? Dr. Ovens explains how we must maintain vigilance in our EDs and not let our guards down. COVID-19 is not going away anytime soon...
Bjug Borgundvaag expands on "the mission" aspect of the COVID-19 pandemic for EM and explain why this might just be the best moment ever to be an emergency physician...
COVID-19 is a character-defining moment for us as individuals, EDs, and communities, and even as a country and a species. How will you look back on this period?...
In this guest Waiting to Be Seen blog by Dr. Gaibrie Stephen, we discover the evidence supporting a more rigorous and professional approach to language translation services as well as some practical available options. If a lack of translation can have tragic consequences, the obligation of an ED to set a new and better standard of care for communicating with patients is now painfully clear...
Are there things we can do in the ED to reduce the risk of violence? We focus on some of the high-risk populations that are often involved in situations that escalate and suffer the consequences of ED responses. Let's move beyond non-violent de-escalation, examine our underlying attitudes, and explore strategies to prevent escalation on this Waiting to Be Seen blog...
We often face violence in the ED. Yet the ED is a sanctuary for care and support. Many EDs have a zero-tolerance policy for violence. In this Waiting to Be Seen blog Dr. Howard Ovens examines the issues we face in Emergency Departments as we try to make staff feel safe and ensure patients can access the care they need. He reframes violence in the ED as a public health issue and offers strategies for a safe ED...
Jesse McLaren outlines 10 Quality Improvement (QI) opportunities for reducing missed AMIs and the lessons learned from Ontario’s Emergency Department Return Visit Quality Program in this Waiting to Be Seen blog...
It’s been another trying flu season in the northern hemisphere—for patients and for emergency department (ED) providers. EDs that are crowded at the best of times come close to a tipping point, waits to be seen and for beds climb, and hospitals struggle to handle the load, sometimes coping by putting patients in hallways or lounges. Even well-written surge plans fall apart in the face of staff illness or unit outbreaks. Too often when trying to help the system cope, a hospital, health region, or government puts out a call for the public to stay away from crowded EDs unless absolutely necessary—but are such warnings ethical or effective?
It is both an evidence-based truth and almost a mantra of emergency department (ED) providers and leaders that the major cause of ED overcrowding is boarded patients. Yet 10 years of experience in more than 70 EDs has shown that impressive flow gains can be achieved despite a poor flow of admitted patients out of the ED. While I have always been and continue to be an advocate for improved admission processes and better ED resources, these issues should never excuse us from exploring our own role in improving flow in our departments. Fostering a culture in which all staff are committed to improving care through better flow will trump petty concerns about hierarchies and role descriptions—and it will improve morale.