Welcome to the emergency room of the NU-Hospital group

Transcription

1 Welcome to the emergency room of the NU-Hospital group Camilla Högström Head of the Clinic of Emergency Medicine

2 About us We see patients every year, in general 200 every day We hold 7 different specialties (Surgery, Internal medicine, orthopedics, infection disease, gynecology, pediatrics & ear-nose-throat care) And since the fall of 2015 new specialty, emergency medicine We are 100 people in staff every 24 hours Nurses, doctors, nurse assistants & medical secretary.

3 The single largest emergency room in Västra Götaland inhabitants m² ( ft²) emergency room Finished in the spring of 2015 and opened fully in the fall of 2015

4 Trauma at Northern Älvsborg County Hospital Dr Ragnar Ang Senior Surgeon, Head of the Trauma Process Dr Fredrick de Paulis Senior Anestesiologist Head of the Trauma Process

5 Uptake area inhabitants 7657 km2 180 km 180 km

6 Trauma types

7 ORANGE and RED Trauma ORANGE Determined by mechanism of injury: Certain velocity of impact Airbag deployed Certain height of fall (3 mtr) Pedestrian/cyclist hit by car Car flipped over/patient trapped RED Same as Orange Penetrating wounds Head/Torso Unstable pelvic fracture Amputation above hand or feet Severe burn or frost injury Suspicious internal och intracebral bleeding Deranged vital parameters O2 Sat < 90% BP < 90 GCS < 12 Puls >130 Neurological deficit BF > 30/min or < 8/min

8 Traumateam Surgeon (Traumaleader/hands-off) Surgeon (Hands-on) Anesthesiologist Orthopedic surgeon A&E Nurse (x3) Critical care nurse Anesthetic nurse Radiology nurse (x2)

9 Trauma Total Red Orange uppgr. Admitt ICU Ward Home SU Other

10 Trauma group Surgeon Anesthesiologist Orthopedic surgeon Emergency physician A&E Nurse Critical care nurse Anesthetic nurse Radiology Transfusion department Ambulance Crisis & Disaster coordinator OR nurse

11 Trauma group Conducts trauma drills, 16 sessions per year Develops, updates, and improves local Trauma manuals Conduct Mortality & Morbidity conferances Oversees training across all categories Follow up on deviations

12 Trauma drill goals Leadership Communication CRM-criteria curve balls 1.Know the environment 2.Anticipate and plan 3.Call for help early 4.Exercise leadership and followership 5.Distribute the workload 6.Mobilize all available resources 7.Communicate effectively 8.Use all available information 9.Prevent and manage fixation errors 10.Cross (double) check 11.Use cognitive aids 12.Re-evaluate repeatedly 13.Use good teamwork 14.Allocate attention wisely 15.Set priorities dynamically

13 TRAUMA audit fall 2015 Positiv Well organised Well trained Trauma drills Well written manuals Well equiped trauma room at A&E Good Teamwork Good capacity Good follow up on deviations Needs improvement Long public corridor from A&E to OR Long term Rehab Need to develop and build clinical training centre

14 We have been tested

15 October 22, Days after the trauma audit School attack by a lone perpetrator 1 Dead at site 3 Stabbing victims 1 GSW (perpetrator shot by police) Within 10 minutes 5 traumateams ready Within 15 minutes 5 OR ready

16 Logistics of the tour We will divide you into 2 groups. Group 1 Host: Dr. Fredrick de Paulis, Head of the Trauma Process Ambulance station Trauma room CT-lab Operation theater ICU Coffee room - Emergency care chain improvement work Group 2 Host: Dr. Ragnar Ang, Head of the Trauma Process Coffee room - Emergency care chain improvement work Ambulance station Trauma room CT-lab Operation theater ICU

17 In case of large emergency incident during the tour Your host will guide you to a conference room near by where the tour will be substituted with short talks by our trauma experts.

18 We will meet back here at for some traditional Swedish fika!

19 Emergency care chain improvement work Caroline Fruberg Improvement leader of the emergency care chain

20 Picture concept idea: WHO

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23 Improvement model Empowerment Values * Put the customer in the center * Work with processes * Work with improvement * Base decisions on facts * Create an environment for participation * Engaged leaders

24 Process oriented improvement work Contributes to greater consensus, patient focus, reduced variation. Process oriented development Means greater patient safety, increased efficiency and simpler planning. Process mapping

25 Patient involvement National patient survey Installed digital patient feedback system Open-question survey in the emergency room. PATIENT FOCUS

26 Physical environment; 6 WHAT IS IMPORTANT TO YOU? Safety and feeling cared for; 7 Other; 4 Personal interactions; 19 Integrity; 1 Good care; 3 Organization; 11 Information; 14 Practical issues; 8 Waiting time; 23

27 Examples of our improvement work Surgical doctor team directly Reduces time spent on in the emergency room, better patient satisfaction and better staff satisfaction. Real time information for patients on current strain on the emergency room. Personal/patient specific written information on received care, planned follow up and self care activities. New processes aimed at shortening time spent waiting for triage.

28 Thank you!