Communication is the Key Journal 5

Well everyone,
I have done 8 hours of clinicals this week. The director started off his day as usual with checking his emails and voicemails. He also had to follow up with a couple of patients via telephone in regards to the care they received in the emergency room and questions regarding their bill. The manager has the responsibilty of maintaining staff and patient satisfaction. I also attended a "door to balloon" meeting yesterday. The Emergency Department is really progressing in their door to balloon time with their STEMI patients. This is the time it takes for the patient to go from the ED to the Cath Lab because we know that time is muscle.
Today, I attended a director's meeting. The meeting was lead by the ED medical director in reference to the increase in occurrence reports on patients that were sent to the floor. The ED medical director felt tha this could have been handled better with effective communication as opposed to writing occurrence reports. There were a series of barriers that ED was encountering from the floor in regards to admissions. Effective communication is one of the main qualities that a leader/manager should possess. Having a positive attitude is also another important quality of a leader because this can have a major affect on the attitude of the staff and can also affect patient satisfaction. Therefore, the medical director wanted to discuss the change of attitude amongst the different departments in the hospital. For example, the ED has an Angina Pathway implemented by the hospital that is being rejected by the medical floor because the nurses are saying that it doesn't meet criteria which is causing a major delay in patient flow and patient care. This has caused animosity amongst the hospital staff. The floor is stating that they don't do Chest Pain patients until they have 2 cleared troponins in the ED. The ED medical director stated that they are not admitting Chest Pain patients to the floor. For example if a patient is diagnosed with pneumonia and the patient has a history of CHF then they will order lasix and write the orders on the Angina Pathway. The problem seems to be the title of the orders which read Angina when admitting these patients. Another main issue is that if a patient goes to a floor that doesn't require that level of care then the hospital does not get paid. This is due to managed care by the insurance companies. The ED director stated that this past month ER patients stayed 1600 hours total in the ED waiting on admission beds. This can have a major impact on patient care. She believes that the departments need to have a common goal: the best quality patient care possible. The medical charge nurse stated the medical floor is med/oncology and the nurses on that floor does not have ACLS nor can they read EKG strips. The rest of the department managers seemed to be unaware of this. So they decided that education was one of the ways in solving this problem and decided to make this meeting a regular monthly meeting until this issue is resolved. The directors decided that they needed to move forward in a positive manner to improve flow of ED and improve care of the patients through education and communication. This was a very informative and productive meeting. It was good to see the directors respect each other, handle constructive criticism, and come together and collaborate with one another to come up with a common goal: Patient care.