Veona ED

What this is

Veona ED (Emergency Department) runs casualty flow end to end: triage assigns an acuity and routes the patient, the live boards track every active visit through the department, resuscitation runs the highest-acuity cases, fast-track streams the minor injuries, surge mode flips the department into mass-casualty posture, observation holds short-stay patients, and disposition records the outcome. An ED visit opens one clinical Encounter on the shared clinical spine, so charting, ordering and billing carry through.

Key terms used on this page:

• ESI — Emergency Severity Index, the 5-level acuity scale. 1 (Resuscitation) is the most urgent; 5 (Minor) the least. (Veona labels the levels 1 Resuscitation · 2 Emergency · 3 Urgent · 4 Standard · 5 Minor and shows them on the board as ESI 1–5.)
• Triage — the front-door assessment that records the complaint, vitals and a pain score, and assigns the ESI acuity.
• Reassessment — re-grading a waiting or in-treatment patient’s ESI acuity when they deteriorate or improve.
• Resus (resuscitation) — the high-acuity bay where the resus team works a critical case, with a timestamped event timeline.
• Bed and zone board — the live floor map: every active visit grouped into a physical zone (Resus, Majors, Minors, Fast-Track, Paediatric, Observation, Waiting) and a bay slot.
• Fast-track — a rapid lane for minor injuries and ailments that can be seen and discharged quickly.
• Disposition — the decision that closes the visit: Admit, Discharge, Transfer, Refer, LWBS or Mortuary.
• LWBS — Left Without Being Seen; a patient who leaves before a clinician sees them. Recording LWBS closes the visit.
• Surge — a declared mass-casualty posture (standby, minor, major, critical) with an inbound ambulance pre-alert board.
• Observation unit — a short-stay area for patients who need a few hours of monitoring before a disposition decision.

Who uses it

• ED nurse — triages and treats: runs triage, reassesses acuity, works the bed and zone board, toggles fast-track, logs resus events, manages observation, and logs ambulance pre-alerts.
• ED physician — treats and decides disposition.
• Clinical Admin — manages ED settings, the resus roster, ED order sets, and declares / stands down surges.
• Clinicians and nurses also work the ED floor and can triage and treat.

The Administrator holds every ED capability.

Editions

ED is included in the Hospital and Network editions (and the Veona Enterprise super-bundle). It is not in Health Centre, Veona Labs or Public Health. It depends on Chart. A facility whose edition does not entitle the module sees no ED screens, and any attempt to reach them is refused.

Screens

The Veona ED tabs, as the app names them:

• ED Board — the live emergency board
• Bed & Zone Board — the live floor map by physical zone and bay
• Triage
• Resus
• Observation
• Disposition
• Surge Mode — mass-casualty posture + ambulance pre-alerts
• Tracking — a wallboard of every patient by stage
• Reports
• Settings

The per-visit ED record is reached by drilling a board row, not as a standalone tab.

The emergency board

The ED Board is the module’s landing screen — every active visit in the department, ranked by acuity. A readout strip shows patients in department, those waiting for triage, resus activity, and target breaches.

1. Search by patient, visit, or complaint, and filter by acuity with the Cat 1–5 chips. Sort by acuity, patient, or waiting time from the column headers.
2. Each row shows the visit, patient, complaint, acuity pill, stage, location, assigned clinician, and time waiting (which turns amber past the acuity target and red on a breach).
3. On an unassigned patient, select Assign to give them a clinician and a cubicle/bay; on an assigned patient, select Open to drill into the visit record.
4. Activate Resus (top right) pages the on-call resuscitation team and opens a resus bay — use it for category 1 and peri-arrest presentations.

Triage a patient

1. Open Triage (“Triage Assessment”).
2. On step 1 · Presentation, search for the patient, set the arrival mode (Walk-in, Ambulance, Referral, Police) and time, enter the presenting complaint, optional MTS discriminator and a pain score.
3. On step 2 · Vital Signs, record temperature, HR, BP, SpO₂, RR, GCS, and blood glucose, and flag suspected infection where relevant.
4. On step 3 · Acuity, set the ESI acuity (1–5), then Assign & Route. The patient lands on the board.

Caution

ESI 1 is the highest-priority (immediate) category — the screen surfaces a resuscitation warning and the resus team is paged on routing. Triage promptly and escalate where indicated.

Triage opens one Encounter on the shared clinical spine and captures the ED-ATTENDANCE facility fee through the central billing seam (re-triage never re-bills).

Reassess acuity

A waiting or in-treatment patient who deteriorates or improves can be re-graded. Reassessment writes an audit row (prior + new acuity, with the new vitals) and captures an ED-TRIAGE-ACUITY fee.

Run a resuscitation

1. Open Resus. The screen lists active resus cases; activate the resus team from the ED board to start one.
2. Select Log Event to add a timestamped entry (e.g. “Shock delivered 200J”). The case carries the bay, patient, presentation, team and a live event timeline.

Activating resus pages the on-call roster (configured in Settings) by content-free notification, and captures the ED-RESUS fee.

Work the bed and zone board

1. Open Bed & Zone Board. Every active visit is grouped into its physical zone with its ESI pill, bay, fast-track flag and breach flag.
2. Select Move on a visit to reassign its zone and bay/bed.
3. Select Fast-Track to route a minor case into the rapid lane (or Exit Fast-Track to take it out). The first time a visit enters fast-track captures an ED-FAST-TRACK fee.

Track patients

The Tracking wallboard shows every patient as a card in a column by stage (Triage → Waiting → In treatment → Awaiting results → Disposition). A Full Screen button makes it a department wallboard.

Handle a surge

1. Open Surge Mode.
2. Declare a surge with an event name, level (standby / minor / major / critical) and expected casualties; Stand Down when it is over.
3. Log inbound ambulance pre-alerts (callsign, ETA, casualty count, mechanism, estimated acuity) so the team prepares before arrival; mark each Arrived or Cancel as runs land.

Observation

The Observation screen holds short-stay patients (bay, reason, hours, plan, status: Monitoring / Stable / Escalate). Add a patient with Add To Observation.

Record a disposition

1. Open Disposition. The worklist is every active visit joined with any recorded decision.
2. Open a visit and choose the decision — Admit, Discharge, Transfer, Refer, LWBS or Mortuary — and the destination / follow-up.
3. Admit creates an Admission on the spine and, where a free bed in the destination ward is addressable, occupies it; the admit is completed in Veona Ward (Admit To Ward). Discharge settles the patient’s accrued charges into one final bill (the same idempotent settlement Ward discharge uses) and generates the visit summary. LWBS and Mortuary route through the dedicated pathway endpoint and close the visit.

Emergency reports

Reports turns ED activity into an operational summary for a Monthly or Weekly grain: total visits, mean door-to-doctor minutes, target breaches, and dispositions. It charts visits by acuity and lists the disposition breakdown. Choose the grain with the toggle, or Rebuild Report to refresh.

Note

Statutory and ministry reports are produced in Veona Pulse, not here.

Emergency settings

Settings configures the department, with each change saving as you make it:

• Emergency-department preferences, triage routing (including the acuity floor that lets a case be fast-tracked), and access & audit controls.
• The per-visit custom fields.
• The On-call Resuscitation Team — the staff paged when Activate Resus is pressed, and the default resus bay that opens on activation. Add staff with a team role and set the bay, then Save Team.

Integration

• Ambulance → ED arrival. When an ambulance run with a known patient is handed over to the receiving ED, the handoff mints an EdVisit (arrival = Ambulance) through the same EdService path triage uses — one Encounter, an ED-ATTENDANCE fee, and the visit lands in the Resus zone with acuity derived from the dispatch priority (P1→ESI 1 … P4→ESI 4). The handoff records the new visit’s id. An unidentified casualty, or an external-facility handoff, links no ED visit.
• Chart + CPOE. Fast-track lab / imaging / medication orders and ED order sets reuse the one chart order path, so requisitions and the MAR are the same records as everywhere else.
• Billing. ED facility fees (attendance, triage-acuity, fast-track, resus) post through the central charge-capture seam — Dr AR / Cr Revenue once invoiced — exactly like ward bed-days and theatre procedures. Emergency consumables logged against a stock item draw down from the one inventory ledger (Dr COGS / Cr Stock at weighted-average cost) and bill as ED revenue.
• Pulse. ED feeds the Pulse analytics engine: attendances, door-to-doctor average minutes, breach rate, acuity mix, and admission rate.