1. Grady Emergency Room Visit Janani Venugopalan PhD Student Biomedical Engg.

2. Outline • First Impressions • Observations • Positives • Perceived bottlenecks • Ideas for Improvement

3. Constant Movement

4. Entry to Treatment Patient Waiting Outside Triage Treatment Triage • Care provided in 5 levels • Severe cases transferred if needed

5. Promoted an environment of continuous improvement to patient care Board Monitors Electronic Monitors

6. Elevated Noise Levels in the Patient Waiting Area & Entrance

7. Sample Emergency Room Floor Plan

8. Role specific functions • Adult & Pediatric unit adjacent • Navigator • Door Sizes Small • Communication among nurses • Not much patient vision

9. Functions for each role is well defined and documented

10. Fixed treatment procedure

11. Adult & pediatric units adjacent to each other and connected by a door Adult Trauma Unit Pediatric Trauma Unit

12. Navigator • Specialized role to help patient transfer to other units if required • Continuum of care

13. Role specific functions • Planned treatment • Adult & Pediatric unit adjacent • Navigator • Door Sizes Small • Communication among nurses • Not much patient vision

14. Distributed nurse stations Nurse stations distributed & at inconvenient locations. Not conducive for communication

15. Door Sizes in new ward small Towards patient & wheelchair friendly design

16. Should move towards designs to improve patient monitoring by nurses

17. Communication • Structure

18. Use of current technologies to improve communications

19. Improve patient visibility • Improve accessibility • Reduce noise