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Redrawing the Boundaries: Conceptualizing Emergency Medicine as a Complex Communication System
Unformatted Document Text:  23 The cause of these long and indeterminate wait times seems to be the lack of resources in support departments and the lack of collaboration between these departments and the ED. Obviously, the ER is only one of many areas supported by phlebotomy and radiology, but it is an important one. At CHC, these departments were so busy managing their own workload stress that they sometimes failed to fully appreciate the effect of their long delays on the overall emergency care process. ED staff phoned support departments time and again about missing or delayed reports, with mixed results. Although there are a number of emerging technologies that are used in the practice of emergency medicine, most are not presently in use at CHC. Many EDs are implementing various information systems to facilitate patient flow, reduce wait times, and improve patient throughput. They provide patients with “tailored” information regarding their diagnosis and treatment, and facilitate communication among the staff within the ED as well as between departments. Such systems can provide critical reference resources in a timely fashion (Case, 1998, p. 25). At least some of the current challenges involving interdepartmental communication at CHC could be addressed through the adoption of state-of-the-art communication technology. One of the most striking finding of this study was the marked lack of cross- functional collaboration or systems consciousness about emergency care. Many CHC employees saw the ED as demanding and unreasonable. Major organizational changes during this period added to the problem. For example,

Authors: Eisenberg, Eric., Pynes, Joan. and Baglia, Jay.
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23
The cause of these long and indeterminate wait times seems to be the lack
of resources in support departments and the lack of collaboration between these
departments and the ED. Obviously, the ER is only one of many areas
supported by phlebotomy and radiology, but it is an important one. At CHC,
these departments were so busy managing their own workload stress that they
sometimes failed to fully appreciate the effect of their long delays on the overall
emergency care process. ED staff phoned support departments time and again
about missing or delayed reports, with mixed results.
Although there are a number of emerging technologies that are used in the
practice of emergency medicine, most are not presently in use at CHC. Many
EDs are implementing various information systems to facilitate patient flow,
reduce wait times, and improve patient throughput. They provide patients with
“tailored” information regarding their diagnosis and treatment, and facilitate
communication among the staff within the ED as well as between departments.
Such systems can provide critical reference resources in a timely fashion (Case,
1998, p. 25). At least some of the current challenges involving
interdepartmental communication at CHC could be addressed through the
adoption of state-of-the-art communication technology.
One of the most striking finding of this study was the marked lack of cross-
functional collaboration or systems consciousness about emergency care. Many
CHC employees saw the ED as demanding and unreasonable. Major
organizational changes during this period added to the problem. For example,


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