Table 1 Pacific Emergency Care Assessment (PECA) Table outline

Demographic data

• Presentations – number, type, distribution

• ED relationship with hospital, community

Detailed observations covering all of these areas, including columns / rows for:

• Strengths

• Weaknesses

• Facilitators

• Barriers

• Identified gaps

• Possible solutions

• Recommendations

Pre-hospital

• Transport mode, care, referral system

Triage

• Presentations

• Triage nurses – training, supervision

• Location and equipment, amenity and safety

• Triage system and Clinical resources

• Observation of arrived/waiting patients

• Timeliness, accuracy, documentation

• Provision of 1st aid

Time to treatment

• Nursing/medical

• Notification, sense of urgency, delays

Initial assessment

• Systematic; teamwork; medical / nursing

• Access to lab/radiology; diagnosis and plan

Review of patient and ongoing care

• Nursing, medical, inpatient (IP) units

• Adverse events

Trauma and resuscitation management

• Trauma response

• Teamwork; effectiveness

Women’s health

• Obstetric care

• Sexual violence; privacy

Paediatric care

• Quality and safety

• Environment and equipment

• Staff training, communication, IP unit care

Access to treatment

• Delays; limitations

Handover

• Within ED; to IP units

Patient disposition

• To Theatre, IP units, home

• Access Block

Transport of patients

• Staff, timeliness, safety

Equipment

• Availability; training; maintenance; supply

Infection control

• Staff and patients

• Isolation; cleanliness

Standard and consistency of care

• Protocols and guidelines

• Best practice; EBM; adverse events

Patient information management

• Documentation; communication

• Forms, storage, access, technology use, data for research

Safety

• Critical incidents; error and review

• Staff safety and amenity

ED staff

• Number and rostering; Human resource use

• Education and training level, ED based teaching. Skill mix + supervision

• Scope of practice

Communication

• Between ED staff; ED + hospital staff

• Between staff and patients/families

Culture of ED

• Sense of ownership

• Leadership / responsibility

• Morale + Staff turnover

ED design and patient flow

Comprehensive mapping of ED design and how patients move through clinical areas, including

• Bottle-neck areas

• Access block (all contributing factors)

• Patient tracking

• Design features; amenity; functionality

Aerial diagrams of current and suggested ED layout with patient flow mapping

Recommendations aim to maximise safe and effective use of existing space