Emergency Questions: 1001 conversation-savers for any situation

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Staff undertaking initial assessment should be registered healthcare professionals who are competent in UEC and have received appropriate training. They will need to demonstrate well-developed interpersonal skills so they can communicate effectively with patients and their families in what is often a stressful situation. Individual departments should have an agreed and documented auditable training process for staff that includes a competency framework. Identify patients with non-life-threatening conditions/injuries and ensure appropriate service allocation and prioritisation occurs. identify patients with potentially life-threatening conditions and injuries to ensure those with the most time-critical conditions are prioritised

ED’ in this document refers to the location where the initial patient assessment takes place. Assessment can be performed by a type 1 (ED) or type 3 (UTC) service. Hospitals may have a UTC at the front door which performs the streaming function. The clinical process to prioritise patients, completed before a full assessment to support effective management of demand and flow, identifying time critical requirements for patients. Context Occurs when a patient has been assessed by an appropriately qualified practitioner in an emergency care facility and the decision made to refer them to another specialty for further care. In this case, a full ECDS ED episode has occurred. Context Ambulances will pre-alert the ED if they are conveying a patient who needs to be received by a clinical team. These patients must be received by the appropriate team immediately on arrival.Streaming manages queues and matches patients’ needs to the practitioner and area with the right clinical skills and diagnostic and treatment capabilities at the earliest opportunity.

Identify potentially vulnerable patients including those with safeguarding concerns, learning disabilities, acute mental health illness and high risk of absconding.Technical streaming tools used in EDs may assist in this process. Redirection options are agreed by the hospital on implementing the digital enablers. Examples are community pharmacies, dental services, or other specialist services in primary and community care. Referral Definition The NHS UEC Daily SitRep uses the same definitions for streaming and acuity, and submissions to this collection should be consistent with those made to ECDS. Training in initial assessment This article clarifies NYRx, the New York State (NYS) Medicaid Pharmacy program, policy regarding coverage of hormone therapy for the treatment of gender dysphoria. Previous guidance regarding gender dysphoria can be found in the following Medicaid Update issues: Additional training dates are available for those who are unable to attend the initial training on Thursday, November 16:

Rapid assessment and treatment is the initiation of investigations and treatment as determined by a team including senior decision-makers. Context Transgender Related Care and Services Update article published in the May 2016 issue of the Medicaid Update; and Streaming explicitly assumes protocols are in place that allow patients to be immediately transferred to the ED if clinically required and appropriate. The terminology surrounding patient flow – pre-hospital and from the ED front door – is inconsistent, with terms such as streaming, assessment and triage used interchangeably. Since national implementation of streaming models in EDs in 2017/18, providers have said clearer definitions of initial assessment would be helpful.It takes longer than streaming or triage (often 20 to 30 minutes, depending on the patient) and therefore, if insufficiently resourced, could create a queue to access it. However, it can improve the overall emergency care episode by initiating investigations and treatments early. Note on digital enablers New York State Medicaid Updates Regulations article published in the June 2015 issue of the Medicaid Update.