Emergency Room Patient Data Flowsheet- Dr. Cross

Vision - belief in the concept of real-time recording for the purposes of efficient and effective monitoring of care, and to provide a vehicle (means) for portraying the process of care provided to other providers, with a minimum of time, and effort, and with clarity. ("Organized information is energy" & "Chaos is the biggest constraint to our efficiency" [Peter Drucker, Age of Discontinuity]).
Leadership by the physician ED director or an appointed physician associate and the nurse manager. Willingness to minimize "turf" battles, and learn from using a flexible spreadsheet on patients "dying faster than the workup", patients on whom we begin intervening as we find problems that need correcting, e.g. hypoxia, hypotension, lethal heart rhythm, repeated seizures, severe bronchospasm, etc.
Practice in use of the tool - with stable patients so that when the pressure is on, one is not learning to use a tool for the first time.
Involve all players in training and usage. Respiratory therapists often play a major role, and they can input their results, comments, data from ABG's, respirator settings, etc.
Make this a team effort; all providers sign, as with code sheets - where the physician, nurse, and others sign.
Review the case with those involved within the next 48 hours, when possible, providing copies of the data flowsheet for them to follow. Get their input and share it with others, including me!
Click Here for Slippery Slope Analogy.