Tuesday, September 15, 2015
COMPARTMENTALIZING, PRIORITIZING, ACCUMULATING, AND COORDINATING
COMPARTMENTALIZING, PRIORITIZING, ACCUMULATING, AND COORDINATING: A BIT OF HISTORY:
Guest Blog (DRK) with Oversight (RB)
As an emergency medicine resident in the (very) late 1970’s I serendipitously happened to create one of the earliest renditions of an ED tracking board. Resources being scant, I went to the local office supply, to buy a very large erasable white board, which took up an entire wall. On it were placed strips of colored tape in vertical columns for patient names, chief-complaint, stage of care, pending issues, and anticipated disposition; each room or care-space in the department had its own horizontal row.
Why in the world did I do this? Well, it is of note that after a few years, the hospital became the urban flagship for the University of Florida EM program. I was an attending. Many would wander into the area to see this “device,” and my explanation for its presence was as an attempt to make evident to all what was going on in terms of compartmentalization and strategizing. Before then, in my experience, that cognitive process remained rather non-communal, as it was usually kept within the heads of the docs and head nurses, spoken by mouth, and maybe visible, if at all, only via clipboard rack. This new board seemed a step forward, in that other doctors, nurses, and ancillary staff, could all see what was going on, often at a single glance.* Communication as well as prioritization (compartmentalization) was enhanced.
Now those of you who have grown up in EM and UC medicine since may well find it hard to visualize a world without tracking boards. You may also find it hard to imagine a world without cell phones. But in each of those instances, the world was, indeed, long (long) without these.
Since those earlier times, when working on developing one of the first EMR programs for the ED, placing tracking board functions within an electronic system became a goal. Decades later, even with that functionality, though, we are still, for the most part struggling. Why? Principally because efficient EM practice requires individual, personal, compartmentalization, in addition to whatever may be going on from a global, departmental view.
IMPROVING EFFICIENCY THROUGH PERSONAL COMPARTMENTALIZATION
The Merriam-Webster Dictionary defines the verb compartmentalization as three kinds of actions:
: to separate (something) into sections or categories
: to separate (two or more things) from each other