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Patient flow in ER

Last Updated:  Nov

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This page is designed to help understand the working environment in the department and the processing and flow of the various Patient populations. 

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See All Files in Patient Flow Folder

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Dept. Layout/Function

​Old Yellow (2119) : is now part of the main ER on Firstnet - rooms 24-27 Considered Nurse side 3. Stable Patients.

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Orange Zone (2028):  old MSSU - now CDU holding type area for ER patients as well as for new patients to be seen (main ER)

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MHEAZ/Purple zone (2714):  the new secure Mental Health Emergency Assessment Zone:  for stable ER MH patients awaiting further assessment or admission upstairs - replaces the B4/H6 holding areas.  Can accommodate droplet precaution patients.

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Pink Zone (7233): the old Peds Area; Infectious Respiritory Patients.

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New Yellow Zone (2706):  Past the pay phones to the left. 

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CYEZ -Child/Youth Zone (3136):  Past the pay phones to the right. 

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Written Consent Policy:

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Nov:  There is an update to the written consent forms:  there are now 2 forms, 1 for the patient/SDM to sign, and another for when the patient can't consent and the SDM is not in hospital:  there is no longer an area for the ER doctor to sign for emergency authorization (no good solution yet how to document or authorize for imaging)

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Mental Health Patient Flow

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Covering the new MHEAZ area, medical clearance, etc...

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Go to Mental Health Care Pathway

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Specialist Consults/Admission

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Table showing the Non General Internal Medicine (GIM) Admitting Diagnosis criteria to help guide appropriate choice of consultant service for admission consideration (i.e. who is not referred to GIM).

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Dept. of Medicine admitting subspecialty or service by diagnosis

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ER Minor MSK Self-Booked Visits

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In an effort to help prevent bottlenecking and an outbreak in the ED, we have launched a program, where patients are able to book assessments for minor MSK injuries using an online portal.

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Information (criteria, website, etc..) on ER Minor MSK Self-Booked Visit

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Patient Handouts

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Various patient handouts including multi-lingual COVID self-isolation:

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See All Files in Patient Handout Folder

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Personal activity sheet for patients to monitor symptoms while awaiting COVID results

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Personal Activity Tracking sheet

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Discharge Prescription Delivery Service

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Pharmasave in the hospital has now started delivery service for patients looking to fill prescriptions after an ED visit in an effort to reduce face to face interactions. For patients that are discharged from the ED, if they would like their prescription delivered, please ensure the patient label is on the script, attach the script to the Pharmasave Prescription Service page (located by each unit clerk) and then fax it to 416-778-1771.

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Discharge Home Oxygen Service

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In the minority of cases where a patient (COVID or else) can be discharged from ED but would require Home Oxygen, it is now easier to order oxygen under a patient's OHIP as vendors are accepting more requests.  You may be asked by GEM to help arrange. the H7 transitional navigator might also be of assistance.

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This process, if ordered early in the morning, could possibly be done within the same day.

 

How:       Fax a prescription to the Oxygen tank Vendor

•    There are a few choices:

  •   Vital Aire

 https://www.vitalaire.ca/sites/vitalaire_ca/files/2020/12/30/clr_on_home_ox_e_1_fillable_jan2021.pdf

 

•   Medigas

  http://www.medigas.com/-/media/corporate/medigas/documents/m929/m929-can-fillable.pdf?la=en

 

For the discharge, Ensure to request the vendor to:

1.        DELIEVER a Portable tank to the ED

2.        SET the patient up at home

 

Consider filling out a CCAC request for  LHIN nursing to ensure patient is using the oxygen correctly at home

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