We found that in almost all cases the ED physician wanted to take a wait
and see approach. They prefer to start out behind the 8 ball. Since
the trauma service is technically controlled by the Department of
Surgery we convinced our Director to allow for the lead nurse in the
trauma ED to activate according to protocol. It really was not an
Emergency Medicine decision. Now the activations are called by the
nurses and we have reduced our delays and missed activations by 50%.
The ED physicians still interfere with the process occasionally ( that's
the difference between a 50% reduction and a 95% improvement) but we
keep pounding away.
Activating according to predetermined protocols is much more efficient
if done by nurses!
Dan Burgess RN
Memorial Hospital at Gulfport.
>>> Brian.Green@stjohn.org 01/20/04 03:25PM >>>
We have recently opened a can of worms here and I am wondering how
other institutions across the country activate the trauma team. Our
current system is the triage nurse informs the ED physician of an
incoming patient, then he decides according to our criteria if a trauma
should be activated. In some circumstances, the physicians have taken a
"wait and see approach" to activation, wanting to see the patient
themselves and not rely on EMS triage decisions. I am thinking that
this could crucify us during a verification visit. The ED physicians do
not want to give this up. Any thoughts?
Brian J. Green
Trauma Program Manager
St. John Hospital and Medical Center
313 343 7309
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