Closing the Gap: The Role of Discharge Nurses in an Emergency Department.

Introduction: Patients discharged from the emergency department may require a follow-up appointment with an outpatient specialty clinic. Referral processes vary by clinic, some requiring faxed referrals, some providing appointments immediately, and others contacting the patients directly. The frequency with which patients are successfully connected with outpatient follow-up services is largely unknown.

A blueprint for building an emergency department quality improvement and patient safety committee.

The field of quality improvement and patient safety (QIPS) has matured significantly in emergency medicine over the past decade. From standalone, strategically misaligned, and incoherently designed QIPS projects years ago, emergency department (ED) leaders have now recognized that developing a more robust QIPS infrastructure helps prioritize and organize projects for a greater likelihood of success and impact for patients and the system. This process includes the development of a well-defined, accountable, and supported departmental QIPS committee.

Improving Emergency Department flow through optimized bed utilization.

Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients.

Theoretical framing of high-fidelity simulation with Carper's fundamental patterns of knowing in nursing.

Many nursing programs integrate high-fidelity simulation(HFS) into the curriculum. The manikins used are modeled to resemble humans and are programmed to talk and reproduce physiological functions via computer interfaces.When HFS design negates a theoretical framework consistent with the interpersonal and relational nature of nursing,it can problematically focus simulation on psychomotor skills and the physical body.