Emergency services are “hospital services that provide care for unscheduled visits to a public or private healthcare facility, 24 hours a day, every day of the year, for any person without selection, presenting in an emergency situation, including psychiatric emergencies”* according to the French National Authority for Health (HAS).
These services constitute one of the main points of entry into the healthcare system; moreover, the number of visits to this point of entry is constantly increasing. For example, in 2017, in metropolitan France and the French overseas departments and regions (DROM), 713 emergency departments located in 637 healthcare facilities handled 21.4 million visits.*
During the health crisis, emergency departments also played a crucial role in managing COVID-19 cases, both in terms of screening and treatment.
To ensure the rapid care of medically urgent or unstable patients and to improve the reliability of care in emergency departments, strategies must be implemented to effectively meet patients' needs during crises or health emergencies.
The Emergency Department Nurse (IDA), responsible for ensuring the safe reception of patients in the emergency department
The Emergency Department Nurse (IDA), formerly known as the Reception Nurse and orientation is among the first healthcare professionals to take charge of a patient arriving at the emergency department.
According to the French National Agency for Healthcare and Social Care Performance (ANAP), the triage nurse plays a key role in ensuring the reliability of care.
For the French Society of Emergency Medicine (SFMU), the general mission of the triage nurse is “to provide a personalized welcome to the patient and their companions upon arrival, define care priorities based on expressed and/or observed needs, and, based on these needs, decide on the appropriate care setting. These actions aim to improve the quality of care for patients and their companions from the moment of arrival. They are carried out in constant contact with the attending physician responsible for supervising the operation of the department and the management of patient flow.”
To this end, it is recommended that the Emergency Department Instructor (EDI) adopt best practices to understand the essential points regarding patient identification vigilance, to be able to assess a patient's clinical condition and direct them appropriately, and also to ensure secure communication between healthcare professionals.
The correct identification of the patient is indeed the first step in a process that continues throughout their care by the various healthcare professionals involved. This is why, from the moment of arrival at the emergency department, it is essential to employ robust identification practices in order to secure the sharing of health information and to guarantee patient safety. To learn more about best practices in patient identification vigilance, see our article.
One of the functions of the emergency department is to quickly identify urgent patients. Triage is a practice that has been used for years in war and disaster medicine. It involves efficiently directing a patient to a care area suited to their needs, ranging from discharge home to intensive care. Triage of patients presenting to the emergency department is necessary when the flow exceeds the capacity for immediate care, except in life-threatening emergencies. This triage must begin as soon as patients arrive at the emergency department to ensure the safety of patient care, which is organized according to the severity of their condition and not according to their order of arrival at the emergency reception area. The Emergency Medical Technician (EMT) is responsible for assessing the urgency of the patients' condition. They provide initial care as needed and direct patients to an examination room or the waiting room appropriate to their condition. To be able to assess a patient's clinical condition and direct them appropriately, especially when patient flow is high, it is recommended to use assessment scales that can distinguish priority patients based on their health status while reducing the initial waiting time. Several such scales exist and are worth considering. Let's take the example of the "Emergency Severity Index" scale.
Another major role of the IOA in ensuring the reliability of care concerns the security of transmissions between caregivers.
Transmissions refer to all the methods used to pass information between members of a healthcare team to ensure continuity of care. It involves facilitating the exchange of information and acting as an intermediary. To learn more about transmissions between healthcare professionals, see our article.
SafeTeam Academy and Patient Reception in the Emergency Department
Applying best practices when receiving a patient in the emergency department is a key moment for ensuring safe care in the subsequent stages of the treatment process.
To support healthcare professionals in this process, the SafeTeam Academy has developed a module dedicated to welcoming a patient to the emergency department. Through an immersive video, healthcare professionals are placed in an emergency department to manage a patient presenting with a respiratory emergency. In this module, healthcare professionals explore several points: the practices to implement, the application of non-technical skills for robust patient identification and monitoring, information gathering, and assessing the urgency of the medical assessment. If you too would like to contribute to improving the reliability of care within your facilities, SafeTeam Academy training courses are for you! For more information, write to the following address: contact@safeteam.academy
