Emergency Department Administration
This domain tests triage, patient flow, crowding, documentation, quality indicators, and team communication. The exam expects systems thinking and safe prioritisation under resource pressure.
Core rules
- Triage assigns urgency, not diagnosis; reassess patients when waiting times exceed safe limits.
- Emergency department crowding is a patient-safety issue: use input, throughput, and output measures, including rapid assessment and boarding management.
- Document time-critical decisions, reassessments, and discussions. The record should reflect clinical reasoning, not just orders.
- Use structured handover such as SBAR to reduce communication failure.
- Incident reporting and root-cause analysis target system failures, not individual blame.
Worked example
A patient with abdominal pain waits 4 hours and becomes hypotensive. The correct response is immediate reassessment and escalation, not simply moving them in the queue. Triage categories must be dynamic.
Traps
- Do not use first-come, first-served as triage.
- Do not let boarding patients obscure new emergency arrivals.
- Do not document retrospectively without indicating timing.
- Do not treat a quality metric as more important than clinical safety.