ADMIN

Question 1

COMPLAINT MANAGEMENT

Answer 1

1. Immediate Response
2. Personnel
3. Acknowledge complaint within 24hrs
4. Investigation
5. Formal Response within 74hrs

Question 2

ATS PERFORMANCE

Answer 2

ATS Category		Max waiting time		ACEM target % 
ATS 1	immediate	100%
ATS 2	10 minutes	80%
ATS 3	30 minutes	75%
ATS 4	60 minutes	70%
ATS 5	120 minutes	70%

Question 3

Quality Improvement Cycle

Answer 3

Plan - the change - 1 Mark
Do - implement the change - 1 Mark
Check - monitor and review the change - audit - 1 Mark
Act - revise / review the plan and repeat the cycle - 1 Mark

Exact wording not required statements consistent with concept will be given marks
Taken from Dunn Emergency Medicine Manual 5th Edition Volume 1 Chp 22 Pg 351

Question 4

List six clinical indicators used in Emergency Medicine to measure clinical care and outcomes. (6 Marks)

Answer 4

1 Mark to maximum of 6 for any of:
ATS Compliance
% Access block
STEMI - time to angio / thrombolysis
Admission rates
DNW Rates
Number of deaths in ED
Time to antibiotics
Time to analgesia
NEAT Compliance
Trauma audits
Satisfaction surveys - patients or staff
Staff retention / sick leave
Patient complaints audit
Notes audits
Occupational health and safety audits - staff injuries or needle sticks etc.
Missed results audit

List not exhaustive - taken from Taken from Dunn Emergency Medicine Manual 5th Edition Volume 1 Chp 22 Pg 352 and Cameron Textbook of Adult Emergency Medicine 3rd Edition Section 27.3 Pg 822

Question 5

You have been asked to develop a set of exclusion criteria for your Short Stay Unit. Please list your exclusion criteria ? (4 Marks)

Answer 5

1/2 Mark for each exclusion criteria to maximum of 4 marks.
Patients who should be admitted to in-patient wards - complex medical or surgical problems
Multiple problems
Elderly patient
Paediatric patients
Patients without clear management plan / diagnosis
Patients with intensive nursing requirements
Risk to staff patients - psychotic, violent, forensic history

Taken from Cameron Textbook of Adult Emergency Medicine 3rd Edition Section 26.6

Question 6

Define triage

Answer 6

Answer must include: a process for sorting patients based on the urgency of need for medical care (3 marks)

Question 7

What are the underlying principles of triage?

Answer 7

Answer must include equity (or justice/fairness) and efficiency (2 marks)

May also mention ongoing process, doing the greatest good for the greatest number, fairness/appropriateness of treat those in greatest need ahead of those who arrived before them.

Question 8

Jehova’s witness Blood products - critically unwell bleeding

Answer 8

Child cannot refuse consent for urgent life saving treatment. Neither can their parent.
IF adult has advanced care directive - should follow this.
IF adult does not have capacity to refuse then should treat.
involve Senior colleague in decision, hospital exec and hospital legal team early.

Question 9

Policy writing

Answer 9

policy writing steps