Coordination between the emergency unit, outpatients, laboratory and pharmacy rests on three elements: shared information about the patient, written request circuits that everyone knows, and priority rules agreed in advance. Without them, the patient does the running back and forth instead of the information, and each department works without seeing the others.
Key takeaways
- Coordination breaks down mainly at the boundaries between departments.
- Every request from one department to another should be written, linked to the patient and dated.
- Priority levels are decided in advance, not case by case in the corridor.
- A named lead per department and a regular coordination meeting resolve most bottlenecks.
- A shared patient record with role-based access replaces runners and scraps of paper.
Where coordination between departments breaks down
Within a department, everyone knows the routine. Problems appear when a request, a patient or a product moves from one team to another.
| Interface | Common problem | Coordination rule |
|---|---|---|
| Emergency and laboratory | An urgent test is handled like a routine one | Urgent flag limited to defined cases and visible from the request |
| Outpatients and laboratory | The patient is sent to collect the result | Validated result available to the clinician in the record |
| Prescribers and pharmacy | Illegible prescription or out-of-stock product | Legible prescriptions and a stock-out list shared with doctors |
| Emergency and inpatient wards | The patient waits for a bed that is actually free | Up-to-date bed status and a daily bed meeting |
| Pharmacy and nursing | Product issued with no record of the patient | Stock issue recorded against the patient or the ward |
Example: in Port Harcourt, a patient arrives at the emergency unit in the early evening. The form sent to the laboratory carries no urgent flag; the sample waits behind the day’s routine tests, and the doctor has to phone three times.
Write clear request circuits
A request between departments should not depend on someone’s memory or a phone call. The method has six steps:
- List the requests that flow between departments: tests, medicines, specialist opinions, beds, transfers.
- For each request, set the medium (record or form), the minimum content and the expected turnaround.
- Write the procedure on a single page and post it in each department concerned.
- Name a lead per department, reachable during working hours and on call.
- Walk new staff through the procedure, including locum doctors.
- Review the procedure after every significant incident.
This approach builds on a map of the patient journey, which we cover in our article on mapping the patient pathway in hospital. Example: a clinic in Cape Coast discovers, while mapping its requests, that specialist opinions are requested only by phone and leave no trace in the record.
Set priorities without conflict
Three levels are often enough: life-threatening emergency, relative emergency, routine request. What matters is that each level is defined in writing with the doctors, and that the laboratory and pharmacy can refer to it in case of disagreement.
Plan for out-of-hours situations too. Example: in a clinic in Lagos, the pharmacy closes at 8 p.m. The written rule sets out the emergency stock available on each ward, who can access it and how each issue is regularised when the pharmacy reopens.
Share information about the patient and about stock
Coordination improves as soon as departments consult the same information instead of passing it from hand to hand. The emergency doctor sees the test request and the validated result; the laboratory sees who requested the test and with what priority.
On the pharmacy side, prescribers should know which products are out of stock or close to expiry. Example: a doctor who knows a product is out of stock adjusts the prescription with the pharmacist, instead of sending the patient to search town for a product that cannot be found.
Our articles on digitising laboratory test requests and results and on preventing stock-outs and expiries in the hospital pharmacy cover these two circuits in detail.
Keep coordination alive: department leads and a regular meeting
A written procedure is not enough if nobody keeps it alive. Bring together the leads from emergency, outpatients, laboratory, pharmacy and nursing at regular intervals, for example every week.
Keep the agenda short:
- incidents during the period and their causes;
- requests left unanswered or handled late;
- current and expected stock-outs;
- procedure changes for management to approve.
Example: in a polyclinic in Accra, this meeting takes place on Monday mornings. Every decision is written down, and the relevant procedure is updated within the week.
Coordination between departments and MediFlow
MediFlow aims to connect the emergency department, consultations, laboratory and pharmacy in one tool, with smart medical follow-up, in development.
The on-call roster and handover tracking, already available, help you know today who is on duty in each department at the coordination meeting.
Frequently asked questions
Do we need a dedicated coordinator to get departments working together?
Not necessarily. In a medium-sized facility, a lead per department and a named person in management, often the medical director or the head of nursing, are enough, provided meetings are regular and decisions are written down.
How do we settle a priority conflict between the emergency unit and outpatients?
Apply the written priority rule first. If it does not cover the situation, the lead of the department concerned decides, and the case is reviewed at the next coordination meeting to complete the procedure.
Should every department see the full patient record?
No. Each department accesses the information it needs for its work: the laboratory the details linked to the request, the pharmacy the prescription, the cashier the procedures performed and the patient’s NHIS or HMO coverage. Role-based access lets you apply this principle day to day.
Want to see how MediFlow fits your facility? Request a free demo.
