It was a cold and windy January day in Montreal. The pediatric emergency department’s (PED) waiting room was full of sick children. Most of them had high fever and were either coughing, crying, or vomiting. The average waiting time to see a doctor was more than 8 hours. Exhausted parents were asking the triage nurse why the waiting time was so long in the brand new emergency department (ED). Couldn’t the nurse understand that their small baby was sick and should have triage priority? As one parent became aggressive, the triage nurse called security. The waiting room looked more like a battlefield.
In the meantime, Dr Dash was at his work station looking around for misplaced laboratory results while teaching and reviewing cases with medical residents. As he finished a case, Dr Dash walked rapidly to take the next patient’s chart…the bin was empty. No new patients were there to be seen. How can this be possible when the recently installed giant screen monitor indicates that there are more than 60 new patients in the waiting room? He asks someone to put patients in the examination rooms and returns to his computer screen. Just then, another doctor walks over to take the chart of a new patient and finds the empty bin. With a desperate look on his face, he turns to Dr Dash and calmly says, “Something’s wrong, we NEED change.”
Emergency Department Clinical Decision Support Computerize Physician Order Entry Clinical Information System Examination Room
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Massaro TA. Introducing physician order entry at a major academic medical center: impact on organizational culture and behavior. Acad Med. 1993;68:20-30.CrossRefPubMedGoogle Scholar
Haynes RB, Ramsden M, Mckibbon KA, Walker CJ, Ryan NC. A review of medical education and medical informatics. Acad Med. 1989;64:207-212.CrossRefPubMedGoogle Scholar
Hoffenburg S, Hill MB, Houry D. Does sharing process differences reduce length of stay in the emergency department. Ann Emerg Med. 2001;38(5):533-540.CrossRefGoogle Scholar
Handler JA, Feied CF, Coonan K, et al. Computerized physician order entry and online decision support. Acad Emerg Med. 2004;11(11):1135-1141.CrossRefPubMedGoogle Scholar
Helfand M. Information seeking in primary care: how physicians choose which clinical questions to pursue and which to leave unanswered. Med Decis Making. 1995;15:113-119.CrossRefPubMedGoogle Scholar
Hersh WR. A world of knowledge at your fingertips: the promise, reality, and future directions of online information retrieval. Acad Med. 1999;74:240-243.CrossRefPubMedGoogle Scholar
Hersh WR, et al. Factors associated with success in searching MEDLINE and applying evidence to answer clinical questions. J Am Med Inform Assoc. 2002;9(3):283-293.CrossRefPubMedGoogle Scholar
Derlet RW. Overcrowding in emergency departments: increased demand and decreased capacity. Ann Emerg Med. 2002;39(4):430-432.CrossRefPubMedGoogle Scholar
McCaig LF, Burt CB. National Hospital Ambulatory Medical Care Survey: 2002 Emergency Department Summary, Center for Disease Control Advance Data from Vital and Health Statistics, Number 340, March 1; 2004.Google Scholar
Steindel SJ, Howanitz PJ. Physician satisfaction and emergency department laboratory test turnaround time. Arch Pathol Lab Med. 2001;125(7):863-871.PubMedGoogle Scholar
Cue F, Inglis R. Improving the operations of the emergency department. Hospitals. 1978;52:110-113, 119.Google Scholar
Steindel SJ, Howanitz PJ. Changes in emergency department turnaround time performance from 1990 to 1993. A comparison of two College of American Pathologists Q-probes studies. Arch Pathol Lab Med. 1997;121(10):1031-1041.PubMedGoogle Scholar
Markin RS, Whalen SA. Laboratory automation: trajectory, technology, and tactics. Clin Chem. 2000;46(5):764-771.PubMedGoogle Scholar
Neumeier D, Sator H, Rindfleisch GE, Knedel M. A data processing system adapted to the special needs of the emergency laboratory. J Clin Pathol. 1983;36(8):847-855.CrossRefPubMedGoogle Scholar
Leman P, Guthrie D, Simpson R, Little F. Improving access to diagnostics: an evaluation of a satellite laboratory service in the emergency department. Emerg Med J. 2004;21(4):452-456.PubMedGoogle Scholar
Kilpatrick ES, Holding S. Use of computer terminals on wards to access emergency test results: a retrospective audit. BMJ. 2001;322(7294):1101-1103.CrossRefPubMedGoogle Scholar