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America's Hospitals: In Danger or Bouncing Back?
Slide Presentation by James Adams, M.D.
On November 20, 2002, James Adams, M.D., made a presentation in a Web-assisted
teleconference at Event 2, which was entitled "Emergency Department Overcrowding
and Ambulance Diversion."
This is the text version of Dr. Adams's slide presentation. Select to
access the PowerPoint® slides (183 KB).
Emergency Department Overcrowding and Ambulance Diversion
Jim Adams, M.D.
Professor and Chief
Division of Emergency Medicine
Northwestern University/Northwestern Memorial Hospital
Slide 1
This slide contains an example of a line graph that charts the numbers
of patients registered, treated, and admitted to Northwestern Memorial Hospital
over a 2 week period. Such a record of numbers can be used to help predict
the number of patients admitted through the Emergency Department (ED).
Slide 2
We can predict problems tomorrow by projecting, 24 hours in advance:
- Anticipated ED volume.
- Surgical volume.
- Anticipated discharges.
- Transfers/direct admissions.
- Current hospital volume.
Slide 3
Why would we want to predict problems?
- If we can predict problems that will occur tomorrow, we can respond
today.
- If we fail to adequately respond, at least we can:
- Know that we are optimally managing the system.
- Figure out ways to manage better.
- Know that there is simply no capacity!
Slide 4
Once we predict a problem, then what?
- Notify medical staff.
- Notify managers and key leaders.
- Prioritize work to be done:
- Labs, radiology.
- Placement, rides home.
Slide 5
How can we begin this process?
- The hospital system must work together as a whole.
- The demands of the ED, including bottlenecks, must be monitored.
- 5 level, ESI Triage.
- Real time process controls.
Slide 6
- If we monitor the hospital 24 hours in advance of problems, we also
must monitor the ED on a real-time basis in order to identify unanticipated
problems, bottlenecks, and surges.
Slide 7
Slide contains a picture of a screen showing a real-time monitoring system
report. It shows what is being monitored, the status of that situation,
and brief messages regarding that situation.
Current as of June 2003
Internet Citation:
Emergency Department Overcrowding and Ambulance Diversion.
Slide Presentation by James Adams, at Web-Assisted Teleconference, "America's
Hospitals: In Danger or Bouncing Back?" Agency for Healthcare Research and
Quality, Rockville, MD. https://www.ahrq.gov/news/ulp/hospital/adamstxt.htm
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