# Emergency Department Clerical Best Practices & Workflows
> Master essential ED clerical processes, including the 4-hour rule, medical record tracking, First Nations streaming, and leave application guidelines.

Tags: emergency-department, clerical-training, medical-records, healthcare-operations, hospital-workflow, patient-streaming
## Quarterly Clerical Update: Emergency Department Q1 2026
Operational reminders and process improvements for clerical excellence in the Emergency Department.

## The 4-Hour Rule (EMER/ESSU)
* Defines time between EMER bed slip entry and admission.
* Applicable to EMER, EMER GERIS, and CLINICAL TOX patients.
* **Workflow:** Clerks enter bed slip in EDIS (starts clock) -> Nursing stops clock on EDIS at physical entry -> Admit in WebPAS after 4 hours using 'stopped clock' time.

## Streaming First Nations Patients
* Mandatory identification question: "Do you identify as Aboriginal or Torres Strait Islander?"
* Immediate action: Update stream to FN to ensure culturally safe care and ALO support.

## Medical Records Management
* **Admitting to ESSU/EASS/CSSU:** Use 'Receive Medical Records' function in Tracking & Functions; select specific ward and reason 'Receive Direct'.
* **Discharging Home:** Use 'Single Record Movement'; set destination to '1 HIMS' and reason to 'Return to Medical Records Dept'. Verify (T) symbol for transit.

## HR & Operational Guidelines
* **Annual Leave:** Must check 'Available AL Calendar' on SharePoint before submission. No availability results in denial unless unforeseen.
* **Urgent Leave:** Requests within 2 weeks of roster must be discussed directly with the Coordinator or Rostering Supervisor.
* **Dress Code:** Professional appearance, visible ID badges, and mandatory closed-toe shoes in clinical areas.
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