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Choose a place away from your neighborhood where family members can meet in case you are separated and cannot return home due to a disaster. Identify a friend or relative who lives out of the area for family members to contact if you are separated. Store water in a tightly sealed, nonbreakable plastic, fiberglass or enamel-lined metal containers. Alleviating crowding and minimizing length of stay continue to be major issues in the Emergency Department. Operational improvements such as bedside registration and triaging of patients directly from the waiting room has shown promise in getting critical patients treatment and eliminating assigning beds to less critical patients. However, as patient volumes continue to increase, bottlenecks continue to occur because none of these solutions have solved the underlying problem of flow. The first bottleneck that occurs in the emergency department is tied to the ability to correctly assess a patient’s condition and assign them to the proper area for care.
Designed for 65,000 visits per year, Strong Memorial Hospital in Rochester, NY improved on the triage and radial decentralized concept.


Marymount Hospital, part of the Cleveland Clinic Health System, offered an opportunity to explore the concept further for its 40,000 visit per year ED. The concept of a Ribbon ED evolved out of previous models for radial design and decentralization.
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However, for a significant part of each day, the number of patients presenting is just a fraction of the peak.
Bedside registration can occur immediately prior to or parallel with treatment to avoid delays in either the triage area or exam rooms.
Decentralized supplies allow the delivery of care to be more efficient by introducing concepts from Lean design. A radial plan places staff work areas at the center, maximizing visualization of and access to treatment areas while minimizing walking.
Generally, volume increases incrementally and ideally, staffing keeps pace with this change.


The LGA is now seen as a key player in emergency planning by government departments and partner organisations and this is due to the efforts of both elected members and officers in our member councils. During low census times, there are frequent occurrences when several more patients arrive than staff has planned for.
Many times these patients can be managed by the minimum staff, if they [staff] could visualize the patients in their rooms. However, many ED's are planned in such a way that when an additional patient arrives, a staff member must be added in order to see and care for them. Gritting roads, clearing snow, delivering meals on wheels, collecting prescriptions, free parking and Santa's grottos are just some of the wide range of services councils provide for communities and the national economy as a whole.
These instances drive up costs of care, as there becomes an inefficient ratio of staff per patient.



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