Abstract of Dissertation

Agency : Emergency Department, Designing and Planning, Commissioning.

Objective : • To ensure a well commissioned service in the integrated Emergency Department. • To develop and support an integrated emergency care pathway. • To ensure delivering prompt high quality, safe, cost –effective and accessible emergency care

Background : Designing Emergency Department is challenging. This is purely because emergency medicine is a young speciality and still in a state of flux. Increased growth in volume, pressures for operational efficiency, new operational models for patient flow and new concepts in physical design make planning for emergency services space a complex problem We are trying new things all the time to improve performance and efficiency. We add paediatric waiting rooms and short stay units and ‘fast track’areas and streaming. When all is said and done, is there such a thing as the perfect emergency department? Probably not, but we can get very close. I have had the privilege of planning, designing and commissioning of emergency department at ASTER. There are some essential aspects of emergency department design, that when done right, make a huge difference. Does good design and planning contribute to well being of both patients and staff ? Definitely! Does good design and planning affect efficiency? Definitely! After planning and designing, commissioning comes i.e. brought into use. Commissioning is bringing into use, on time, a facility that has been designed in consultation with those who will use it. It starts at the onset of the project, ie.before building onsite commences and finishes with evaluation after the project has been completed and the facilities brought into use.

Methodology : An Exploratory study was carried out and data was collected. An analysis of various parameters was done and on the basis of which recommendations were given.40 doctors were taken as respondents. Purposive sampling technique is used to select the respondents. An open-ended questionnaire was prepared including 24 questions. Out of all the responses 5 top responses were taken and analysis was done.

Findings : According to most of the respondents, triage 57% is the best way to pioritise the patients and streamlines the process in Emergency. 42% of the respondents suggested that double verification of the doctor's prescription by nurses/pharmacists is the best way to reduce medication error in ED.

Recommendations : This report has made important recommendations which I hope commissioners, clinicians, and policy makers involved in configuring emergency services will consider. The adoption of these recommendations should ensure the delivery of safe and high quality care within the Emergency Department.