Emergency departments develop protocols that reflect best practices and improve patient outcomes. According to the "American Journal of Critical Care," the use of protocols simplifies processes, standardizes care, facilitates patients' safety and reduces costs. Protocols can be used in a variety of clinical settings. Respiratory therapists, intensive care departments, pre-hospital emergency providers and other healthcare entities may have protocols to follow for specific situations.
History
According to the Medical Center of Georgia, there are basically two types of protocols used in emergency departments: protocols meant to speed patient care and protocols meant to standardize patient care. Many protocols have been researched and recognized nationally in healthcare, but organizations are not mandated to institute all protocols. If an organization receives accreditation from an accrediting body such as the Joint Commission on Accreditation of Healthcare Organizations, the organization may be required to report its data on some specific national protocols. Nationally recognized protocols mean that the standard of care is the same whether in a small rural hospital or a large university medical center.
Benefits
Standardization of care with the use of protocols can help reduce medical care costs. For example, there are national standards for the care of patients having a heart attack, so regardless of what hospital a patient is treated in, the same diagnostic tests and treatment are rendered. Protocols prevent emergency departments from ordering unnecessary tests or prescribing treatments that could incur unnecessary costs. Standardization of care protocols is also used by the court system to determine if the performance of care was met appropriately in medical cases.
Standing Orders
Protocols may also be referred to as standing orders. These are order sets which allow treatment to begin based on the patient meeting specific clinical signs and symptoms. When a patient presents with chest pain, for example, the standing order set may allow the nurse to give the patient oxygen, draw specific laboratory tests, and order an electrocardiogram and chest radiograph. By implementing standing order sets, important tests can be completed and the patient can be observed properly so that a physician will have results back in a more timely manner.
Types
Emergency departments use a number of protocols, some national and others more organization-specific. An organization-specific protocol may be a protocol outlining the process of how to manage staffing patterns when patient volumes increase. Common protocols used by emergency departments include order sets for asthma, chest pain, fever in children and sexual assault. Some, though not all, emergency departments have X-ray protocols for injured ankles and knees that can be implemented in triage by the nurse.
Expert Insight
The use of protocols is supported by the Institute for HealthCare Improvement's 100,000 Lives Campaign to reduce mortality and morbidity, and the Institute states that clinical research has increased the number of protocols being used in healthcare, and that these protocols have improved patient outcomes.
References
- "American Journal of Critical Care"; Empowering Critical Care Nurses to Improve Compliance With Protocols in the Intensive Care; Plost & Nelson; March 2007
- Institute for Healthcare Improvement: Overview of 100,000 Lives Campaign
- Medical Center of Georgia: Protocols in the Emergency Department
