Zoning, staffing aim to cut delays, ensure care
Irfan Tramboo
Srinagar, Apr 29: The Sher-e-Kashmir Institute of Medical Sciences (SKIMS), Soura, has ordered a comprehensive restructuring of its Department of Emergency Medicine, introducing a zonal system, fixed staffing patterns, and strict limits on patient stay.
The directions were issued through an official communication following a meeting of the Emergency Medical Board, aimed at ensuring smoother functioning of the department and improving patient care.
A key directive states that no patient shall remain in the emergency wing beyond 72 hours under any circumstances.
According to the communication, the Department of Emergency Medicine will now be organised into three zones—Red, Orange, and Green—to enable proper patient categorisation and deliver care based on clinical requirements.
In the Medical Triage area, six DM or post-DM senior residents will be deployed on a rotational basis, with at least two present at any given time.
Triage services will operate daily from 8:00 am to 12:00 midnight, including Sundays, in two shifts.
The Reception Area will be managed by non-DM senior residents from the Department of Emergency Medicine in three shifts, with two senior residents per shift.
They will serve as the first point of contact for evaluation and initial management of patients.
The Red Zone (Outer Reception–Critical Care Area), comprising 12 beds for critically ill patients, will be staffed by eight postgraduate doctors from the Department of General Medicine (second- and third-year PGs).
Two postgraduate doctors will be deployed per shift across three shifts in a 24-hour cycle, ensuring continuous monitoring and stabilisation of critical patients until they are shifted to the respective specialty units.
The stay period in the Red Zone has been restricted to 1–2 hours.
The Orange Zone (Inner Reception–Intermediate Care Area) will function round the clock under non-DM senior residents on a shift basis, supported by junior residents for sampling and monitoring vital parameters.
At any given time, two senior residents and four junior residents will be present. The stay period in this zone will be less than 24 hours.
The Green Zone (Medical Observation Ward), functioning on the pattern of a General Medicine ward, will be managed by postgraduate students along with senior residents as per routine ward protocols.
At any point, one senior resident and one postgraduate doctor will be present. The stay period in the Green Zone will be less than 72 hours.
The directions reiterate that no patient shall remain in the emergency area beyond 72 hours, and any deviation must be reported immediately to the Director SKIMS and the Executive Officer.
Further, the Control Room has been tasked with submitting daily census reports to the concerned Heads of Departments and the Director SKIMS, clearly indicating patient details, duration of stay, and the name of the consultant under whose care the patient has been admitted.
The order also mandates that evening rounds in the Department of Emergency Medicine be compulsorily conducted by senior residents.
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