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Hi
Just wondering if there is any work/research/thoughts anywhere about what are the minimum standards to work in an ER. I see some ERs have no lab or XRAY. Some have limited POC. Some have one nurse and others have none. In some ERs , the docs are first call.
Is there a link between the population, which in turn dictates the acuity and frequency of the cases and the minimum standards ER docs need to have to support quality care?
Just curious if anyone has ever thought about this?
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Interesting and important issue. My feeling is that Canada has lagged behind other countries on this one, and in fact this is something CAEP has been talking about addressing since back when the work of the "Collaborative Working Group on the Future of EM in Canada" was underway.
Australia, in particular, is impressively organized in this regard. Have a look at the categorizations and descriptions at this link:
Of particular note, it's interesting to see see that Australia stipulates that "Level 1 EDs" (locations with the least resources) should be "part of a regional EM Network".
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In Victoria we have started micro-dose inductions of patients with opioid use disorder to build on the success of standard opioid inductions started in 2017 ( over 200 to date! ).
We want to make this a minimal barrier process, ideally with patient leaving with a blister pack of Suboxone micro dose with instructions and daily partitioned doses and linkage to outpatient OAT providers. It may take several days to get to outpatient provider so dispensing multiple days of the induction regime makes sense.
We have come up against a hard barrier of inability to dispense more than 24 hours of medication from the ED according to our pharmacy colleagues.
Is this a legislative barrier, an edict from college of pharmacies or a local health authority ( Island Health) issue?
Has anyone been able to set up a program that allows them to dispense blister packs from the ED for this vulnerable population?
It seems with the opioid death rate and the extra financial and political resources cast into this arena that this sort of barrier should be easily surmountable?
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Hey Jason,
By what authority/mechanism does our pharmacy (I work in Vic too) dispense a 5 day starter pack of HIV PEP meds? If they can do it for one indication, why not another?
Dr. Johann Kriek
January 14, 2021 • 24 Views