Table 2


Standardisation of huddles
Leader: flow nurse.
Public: the entire team on site.
Communication of the overload level: green to black.
Review of professionals and staff: secretariat, admission, security, nurses, doctor interns, executive doctors.
Verbalisation of problem: input and/or emergencies (throughput) and/or output.
Implementation measures, re-evaluation: within 1 hour.
Measures to fight against overcrowding
Input problemStrengthen the triage team?
Intensify referral of patients to other partners to avoid oversorting?
Reconvene the next day?
Redirection of ambulances?
Hospitalise from the moment of reception by bypassing the emergency room?
Throughput problemInforming users.
Recall the five rules of good operation.
Tag to move; if possible, use the pink tag.
Rediscuss the sitting position of patients lying in waiting area C.
Limit unnecessary or non-urgent complementary examinations by cross-checking complex cases.
Put pressure on the upstream and speed up hospitalisations.
Understaffing of medical and nursing staff deemed unsafe by the flow nurse–triage doctor team may lead to the closure of a room in sector C to speed up the care process by increasing the level of overload, or in sectors A or B in order to balance the workload of the sectors/staff.
Output problemCheck bed availability by contacting the bed management unit.
If no inpatient bed, activate corridor bed procedure in an inpatient unit.