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Scheduling of demand pre-emergency department
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This article is part of a series written by Optum Clinical Director and Consultant Emergency Physician, Dr Haidar Samiei. Read the previous article in the series here.
As it stands, we’re starting to see increased uptake of scheduling patients into emergency departments (EDs) from other services – including primary care, out-of-hours, community, 111 telephony, 111 online and hospital access hubs. Patients arrive expected and known to the urgent and emergency care (UEC) footprint, which is a huge advantage for the ED team, allowing them to prepare and manage resource accordingly. Symphony enables ED teams to access documentation regarding the triage process. On top of this, the GP record viewer within Symphony shows every detail of the consultation that prompted the referral, providing the full patient record and enabling informed decisions about patient care and where they should go.
Are we missing the point of same day emergency care?
If at the point of pre-ED triage, all these patients are directed to the wide lipped funnel that is ED now and not booked into future appointments, clinics or focused services, we risk missing the point of same day emergency care (SDEC) entirely.
Symphony can provide appointment slots to specific areas or services within the UEC footprint for referrers to choose from, rather than just act as a receiver of information for patients told to go to the ED. We can ask patients to attend the department most appropriate to them at a time most appropriate to them – whether that’s this evening, tomorrow or in a few days - via a scheduled slot to the department. This means the patient can be triaged before they’ve even arrived at the ED.
What can be done?
Whilst the capability is there, the challenge is learning how to schedule or signpost patients to the right area the first time. To do this we not only need more SDEC - like services and defined pathways for more of the working week. We also need to be able to reliably tell patients treated in one part of the UEC footprint to come back for completion of care at an allotted time slot. With the right technology and processes, we could manage this demand more safely, spreading it out, and funneling it to the right service at the right time to be dealt with efficiently.
Read the next article in the series where Haidar explores scheduling demand from within the emergency department.