Mini-disaster’ system promotes teamwork

 A "mini disaster mode" implemented by the ED at William Beaumont Hospital in Royal Oak, MI, has resulted in increased cooperation among other departments, according to Andrew G. Wilson, MD, FACEP, chairman of the department of emergency medicine.

Although the "Code Purple" is called only two or three times a month, there have been unexpected benefits, he notes. "We have been delighted to find that the mere availability of such a resource has encouraged other areas in the hospital to become wonderfully creative in finding solutions to the underlying problem of ED overload," Wilson reports.

For example, the ED recently was overwhelmed and consulted the in-house nursing supervisor about invoking Code Purple. "We decided not to call it, because help remarkably materialized so that it became a moot issue," he recalls.

The use of Code Purple puts the rest of the hospital on notice that the ED’s problems really belong to the hospital as a whole and must be solved by collective action, says Wilson. Because of Code Purple, other departments have come to view the ED’s problems as hospital problems, says Wilson.

"We are a community of departments, not an archipelago of islands," he emphasizes. "We must function as a community to provide the best care possible for our patients."

The system raised awareness of the intensity of service in the care of emergency patients, says Val Gokenbach, RN, MBA, director of emergency services and observation. "On the inpatient side, limited bed capacity creates somewhat of a controlled environment," she notes. "In the ED, depending on volume, safe patient ratios may be exceeded without the ability to control the environment."

Gokenbach acknowledges that the system couldn’t be implemented without administrative support. "We were grateful to be met with an open-minded approach by the institution," she says. "The intent is to view all patients as our patients and to work proactively with all hospital departments to expedite quality care." The Code Purple system increases teamwork with all the departments involved, says Gokenbach. "The ED arose as a department with a plan and not a department that complains," she adds.