The Emergency Service for adults ( AU – Atendimento Urgente ) at Hospital da Luz Lisboa receives on average, everyday, over 200 clients, having reached the 300 in particular times of the year, with a waiting period of under 45 minutes. These numbers are possible through a rigorous planning and management of teams, as explain in this Hospital da Luz Podcast the clinical coordinator of the service, the internist Luís Duarte Costa, and the manager Pedro Geraldes, of the hospital’s executive board. Hospital da Luz Podcast is the title of a series of podcasts, where the professionals of the group discuss the latest topics in their areas, and that are made available on audio streaming platforms (Spotify, iTunes, Google Podcast, etc.), and also on YouTube. Listen to Hospital da Luz Podcast on the theme: How does the emergency service operate? Google | iTunes | Spotify “In case of emergency, we have the capacity and are prepared for everything” The Emergency Service at Hospital da Luz Lisboa “is a multivalent emergency room, with a capacity comparable (level 1) to that of the central emergency rooms of the hospitals in the National Health System, in the capital”, explains Luís Duarte Costa. There are permanently two teams in the ER – one integrating General and Family Medicine doctors, and another integrating Internal Medicine doctors –, “who solve the great majority of the situations”. Whenever necessary, they are articulated with a third team, integrating elements from other specialities and acting as a consulting body. “Therefore, in case of emergency, we have the capacity and are prepared to deal with all kind of pathologies”, including cases of stroke, infarction or sepsis, highlights the clinical coordinator of the service. The infrastructures of Hospital da Luz Lisboa Emergency Service were expanded over the last year, through the opening of the third building of this hospital unit. But for the success of its functioning, “it is important that management and clinical body are on the same page”, explains, on the other hand, manager Pedro Geraldes, advancing that all that is done is closely monitored. In 2019, on average 205 patients a day were received here, but there were “peaks” where they reached the 300, “some of them with serious conditions”. The waiting time in screening and assistance, and the global duration of permanence in the hospital, from entry to discharge, are considered “fundamental”, besides the quality of service. Therefore, they are subject to constant evaluation, enabling to adjust the teams to the needs generated by demand. Thanks to this work, over the last year the waiting times were reduced by half, with immediate effect and a reduction also in clients’ complaints. “Every emergency room must work promptly and we have managed to ensure to 80-90% of our patients waiting times of under 45 minutes”, advances Luís Duarte Costa, stressing that this value “is extraordinary, when compared, for instance, with the screening system in Manchester” (that estimates 2 to 4 hours, according to the severity of cases). As for the period of permanence of the client in the hospital, since admittance until the final decision on his case, and with all exams concluded, “it should be under 4 hours”, according to the goals established. In parallel, the ER is involved in an innovating project, LUZ 24 , a clinical screening phone line, ensured by nurses who apply rigorous protocols and refer adequately each case. “LUZ 24 is receiving about 200 calls a day”, reveals Pedro Geraldes. The Emergency Service and COVID-19 Reminding that the “Emergency Service is for emergency situations” – meaning that it should not be used as an entrance way for consultations, exams and other hospital services –, Luís Duarte Costa and Pedro Geraldes explain the alterations introduced, that allow to respond to suspected cases of COVID-19 . “We have established a pre-screening, and immediately direct people with symptoms to a specific area of the ER. Ultimately, we have duplicated everything (teams, observation services, sample collection desks, etc.). And we never stop”, explains Luís Duarte Costa.
