Twitt-ER: Using Twitter in The E.R. for Dispatch, Order Com, Patient Alerts and Progress Reports towards the Waiting Room.
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Abstract
An effort is made in our E.R. to channel the work flow, to smoothen the sometimes chaotic processes which take place in the E.R., where the most unexpected is always very probable to happen.
Because of the shortage of E.R. Physicians in Belgium (as in many surrounding countries) our doctors have to carry out very diverse tasks, on many categories of patients.
It is however the triage nurse and a process coordinating nurse who dispatch patients and tasks towards the physicians, so as to enable the physicians to take care of the patients. Because of the large surface of the E.R, a trip to the dispatch room between every patient contact relatively costs a lot of time.
Also, in an effort to eliminate unnecessary chatter, task assignation for nurses, doctors and other staff are not communicated by telephone. This means that all assignments are either passed on by paper (work) order, or computer order (via intranet). Most of these orders or tasks are assigned to a specific person, some are aimed at a certain workforce, such as transport of patients to X-ray, CT, or to their rooms after admission. The detail of this order is always stated in a paper or electronic document.
As in other applications in Medicine, (medical) alerts have proven useful in different applications. Setting up an alert system however, is usually a task for the I.T. Department, after enlightening them about the system or process the E.R. is using for work flow determination.
Because of the constant dynamics of the E.R., it is not always easy or efficient to communicate every task or change in task to every doctor, nurse or other personnel at the right moment. Also, it might be very dependent on the technological backup a hospital can provide.
As we are bringing our E.R. and hospital workflow organisation grid into the 21st century, we are now making grateful use of Twitter for communicating assignments from dispatch and triage towards and between dispatch, triage, doctors and nurses. We do this through the use of closed twitter accounts.
The Triage nurse sends a tweet to the respective doctors indicating which patient to see after the current one, updating in the same tweet the waiting room status with a code and a link to the patient overview. The lab tweets the doctor on his iPhone or GSM when results are ready and includes a link to the intranet page with those results. The doctor tweets the nursing station about an order to be executed. A Twitter feed on a large screen in the waiting room keeps the patients updated about the dynamics of the E.R. and involved in the process. The same page is displayed on screen in the patient treatment areas, as the only screen patients can see on the PC: the patients can tweet the nurse for specific requests while waiting. Patient names are never used.
Patients and staff are better informed, feel efficient and have the impression of being more involved.
Because of the shortage of E.R. Physicians in Belgium (as in many surrounding countries) our doctors have to carry out very diverse tasks, on many categories of patients.
It is however the triage nurse and a process coordinating nurse who dispatch patients and tasks towards the physicians, so as to enable the physicians to take care of the patients. Because of the large surface of the E.R, a trip to the dispatch room between every patient contact relatively costs a lot of time.
Also, in an effort to eliminate unnecessary chatter, task assignation for nurses, doctors and other staff are not communicated by telephone. This means that all assignments are either passed on by paper (work) order, or computer order (via intranet). Most of these orders or tasks are assigned to a specific person, some are aimed at a certain workforce, such as transport of patients to X-ray, CT, or to their rooms after admission. The detail of this order is always stated in a paper or electronic document.
As in other applications in Medicine, (medical) alerts have proven useful in different applications. Setting up an alert system however, is usually a task for the I.T. Department, after enlightening them about the system or process the E.R. is using for work flow determination.
Because of the constant dynamics of the E.R., it is not always easy or efficient to communicate every task or change in task to every doctor, nurse or other personnel at the right moment. Also, it might be very dependent on the technological backup a hospital can provide.
As we are bringing our E.R. and hospital workflow organisation grid into the 21st century, we are now making grateful use of Twitter for communicating assignments from dispatch and triage towards and between dispatch, triage, doctors and nurses. We do this through the use of closed twitter accounts.
The Triage nurse sends a tweet to the respective doctors indicating which patient to see after the current one, updating in the same tweet the waiting room status with a code and a link to the patient overview. The lab tweets the doctor on his iPhone or GSM when results are ready and includes a link to the intranet page with those results. The doctor tweets the nursing station about an order to be executed. A Twitter feed on a large screen in the waiting room keeps the patients updated about the dynamics of the E.R. and involved in the process. The same page is displayed on screen in the patient treatment areas, as the only screen patients can see on the PC: the patients can tweet the nurse for specific requests while waiting. Patient names are never used.
Patients and staff are better informed, feel efficient and have the impression of being more involved.
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