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Letter to the Editor

Pull till Full is Cutting Edge

doi: 10.1097/01.EEM.0000552811.58219.20
Letter to the Editor


Dr. Edwin Leap needs to move forward in the world of operations! (“‘Pull Till Full’ Pits Nurses against Physicians,” EMN 2018;40[11]:1;

Pull to full is inarguably considered by most ED operations experts to be a best practice. The days of empty treatment rooms in the ED with a full waiting room (because the physician is feeling stressed) are over. Marrying pull to full with advanced triage order sets (nurse implemented, chief complaint-driven, approved by the physician group) are cutting-edge ED patient flow strategies. They allow the department to flow smoothly even when the physicians are tied up.

Patients are not satisfied when kept for long periods in the waiting room. In the current era of emergency medicine, we care about patient experience and satisfaction. It is no longer enough to provide good medical care. What was the experience for the patient?

The new practice model is no longer physician-centric. Cutting-edge departments are looking at how the team can deliver timely care where patients are happy with the encounter. Join your nurses and staff in embracing pull to full with advanced triage order sets. Poke your head in, and say hi to patients even when you are busy, and watch patient satisfaction soar! And do feel uncomfortable when patients are staring at you and wondering what the delay is. You should feel their distress.

Shari Welch, MD

Salt Lake City, UT

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