Professional Documents
Culture Documents
--English Dictionary
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Objectives
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Common Scenario today at 1:00
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Etiology of Chaos:
Unscheduled visits
Unscheduled illness or injury
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What causes all of the chaos? What makes the ED different than
the rest of the house?
Unscheduled visits
Unscheduled illness or injury
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Unpredictable demand variation:
Seasonal, Day to day, Hour to hour
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What causes all of the chaos? What makes the ED different than
the rest of the house?
Unscheduled visits
Unscheduled illness or injury
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ED Acuity
Acuity
3500
3000
2500
2000
1500
1000
500
0
Acuity 1 (0.5%) Acuity 2 (36.8%) Acuity 3 (44.9%) Acuity 4 (17.4%) Acuity 5 (0.8%)
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What causes all of the chaos? What makes the ED different than
the rest of the house?
Unscheduled visits
Unscheduled illness or injury
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Fixed capacity
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What causes all of the chaos? What makes the ED different than
the rest of the house?
Unscheduled visits
Unscheduled illness or injury
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Non-Trauma High Intensity Patient Types
STEMI
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Non-Trauma High Intensity Patient Types
Stroke/ICH
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Non-Trauma High Intensity Patient Types
STEMI
Stroke
Psych/Behavioral
Critically Ill:
Peds
Adult
Respiratory failure
Cardiogenic shock
OD
Sepsis
Sedation
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How different in Cedars-Sinai than other medical centers?
We take care of very complex patients
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Whats in the future for the CSMC ED?
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Strategies to manage chaos
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Strategies to improve efficiency, capacity & flow
Space:
Hallway beds and even more hallway beds
Gray Team: Imaging overflow 4:00 pm daily
Flow:
Triage Phlebotomy
Provider (PA) assessment & order entry in Triage
EDCTSICU of critically ill Trauma patients
Imaging:
Imaging Flow Nurse
CT Coordinador
ED Flow Nurse
ED CT Suite
Communications:
ED to Inpatient Report/Nurse hand-off project
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We do organized chaos well
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