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Redrawing the Boundaries: Conceptualizing Emergency Medicine as a Complex Communication System
Unformatted Document Text:  32 “Synchronous Workshops” are just two examples of established methods for breaking down professional silos to make much needed systems change. After having some success in manufacturing, Hammer (1994) introduced the concept of “re-engineering” to health care. “Re-engineering,” as it pertains to any enterprise, requires a rethinking of a process in order to achieve improved quality, service, and speed. Incredibly, these kinds of collaboration are not yet the norm in U.S. hospitals. Instead, EDs take the heat for patient complaints, while they are only one player in a complex chain of service that includes paramedics, phlebotomy, and radiology, as well as housekeeping, registration, and floor nursing. Patient feedback is useful for service and process improvement, but only if those getting the feedback have the ability to communicate what they have been told to a broad coalition of stakeholders sharing a commitment to making positive, systemic change. For it is only when we invite multiple perspectives—i.e., when we acknowledge that emergency medicine is not a place but a process—do we gain the ability to understand the varied sources of present challenges and how they might be addressed most effectively.

Authors: Eisenberg, Eric., Pynes, Joan. and Baglia, Jay.
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32
“Synchronous Workshops” are just two examples of established methods for
breaking down professional silos to make much needed systems change. After
having some success in manufacturing, Hammer (1994) introduced the concept
of “re-engineering” to health care. “Re-engineering,” as it pertains to any
enterprise, requires a rethinking of a process in order to achieve improved
quality, service, and speed.
Incredibly, these kinds of collaboration are not yet the norm in U.S.
hospitals. Instead, EDs take the heat for patient complaints, while they are only
one player in a complex chain of service that includes paramedics, phlebotomy,
and radiology, as well as housekeeping, registration, and floor nursing. Patient
feedback is useful for service and process improvement, but only if those getting
the feedback have the ability to communicate what they have been told to a
broad coalition of stakeholders sharing a commitment to making positive,
systemic change. For it is only when we invite multiple perspectives—i.e., when
we acknowledge that emergency medicine is not a place but a process—do we
gain the ability to understand the varied sources of present challenges and how
they might be addressed most effectively.


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