Para quem adora falar na "vala comum do SUS" ou na "falência da saúde pública", nada melhor do ler o Emergency Department - Pulse Report 2008 onde se apresenta um perfil dos pronto-socorros americanos. O relatório discute muito o tempo de espera e de permanência. Maior do que os observados em pronto-socorros paulistas, com certeza. Aliás, essa foi experiência minha como paciente nas unidades de emergência de Boston há dez anos. Abaixo, uma ação de hospital da Dakota do Sul para reduzir espera no pronto-socorro.
Triage: The hospital condensed the questions that triage nurses ask, made the route patients travel within the department more direct, and started requiring triage nurses to assign patients to their next nurse — rather than waiting for somebody else to do it at the next stop.
The Next Step: After triage, patients see a nurse and doctor simultaneously, rather than the old method of nurse first, doctor second. If the nurse isn’t ready, the doctor can go ahead and treat the patient without waiting. For common ailments, there are set protocols folks in the hospital can follow if a doctor is delayed. For instance, patients with likely fractures can get X-rays while they wait.
“Universal” Rooms: These are equipped with bedside supplies that allow the hospital to care for 85% of problems patients arrive with at the ER. Other supplies can be rolled to patients on carts. The idea is to keep patients from having to move around and employees from stepping on each others’ toes as they walk around to gather supplies.
Paperwork: Registration functions such as getting patients’ addresses and payment information take place at the bedside, after care has been started.
Who Goes Where: The hospital did a deep dive into its data to figure out where patients typically end up after going through the ER. Each department is expected to prepare daily to admit the number of patients it tends to get, so that it can pull them out of the ER quickly.
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