Emergency department software: the first hour, from triage to a bed or home
Emergency department software has one hard job: keeping pace with the first hour, while the patient is triaged, treated and sent on. This guide sets out what an emergency record must hold, follows one case through OPALEVI from the door to a bed or home, and lists what to ask before you choose.
Key takeaways
- An emergency record is read for its times and decisions: when the patient arrived, when they were seen, what was done and where they went.
- Keep the first assessment and the reassessment side by side, so the second never erases the first.
- Know what the software calculates: in OPALEVI the waits are worked out and the GCS total and the burned surface added up; the triage colour and NEWS2 are your team's.
- Instructions, return signs, prescriptions and referrals should print from the record, never be typed twice.
Where triage cards and general programs break down
Many small hospitals still run the emergency department on a triage card, a clinic program built for booked appointments and a phone to the ward. On a busy evening the gaps show in the same places:
- Times nobody adds up. Arrival, assessment and decision go on the card; the wait is worked out later, or never.
- A reassessment written over the first finding. One box per letter keeps only the second answer.
- Burns totalled by hand, superficial ones left out, at two in the morning.
- Decisions lost at handover. The ward rings down to ask what was given, and when.
- Advice said, never written. The patient goes home with nothing on paper about when to return.
A general clinic program is shaped like an outpatient consultation. An emergency case is shaped like a clock with a decision at the end, and needs a record built that way.
In an emergency department the record is not a summary written afterwards. It is the timeline of the first hour, kept while it happens.
What an emergency record has to hold
Whatever you use, paper included, agree first on what any emergency record must answer:
| Field | Why it matters |
|---|---|
| Mode of arrival | On foot, by ambulance, referred or brought in: what happened before the door. |
| Triage category | The priority given, in your department's scale, and by whom. |
| Chief complaint | In the patient's or the crew's words. |
| Times of arrival, assessment and decision | The three times a department is judged on, and the waits between them. |
| Vital signs, breathing rate included | The observations the triage decision rests on. |
| Primary survey, first and repeated | ABCDE before and after treatment, kept apart. |
| Glasgow Coma Scale | Its three parts, not only the total. |
| Injuries and burns, located | Where each one is; for burns, the depth and the share of body surface. |
| Decision, handover and instructions | Where the patient went, what the next team must know, what the patient was told. |
Record-keeping, not triage
Software can hold the category, the observations and the times. It cannot triage: the scale, its discriminators and the target for each category stay your department's protocol.
The first hour of one case, step by step, in OPALEVI
One case through the Emergency department of OPALEVI for hospitals: a man walks in with a cut hand. Bold words are the labels on screen, and the Emergency department page sums up the record in a line.
Register him at the door
Quick admission finds the person by name, telephone or code, or registers him, and warns before a second file is made. A clinician presses Start the visit; the desk can Add to the queue.
Take the observations
A nurse records the Vital signs, respiratory rate included, then presses Mark ready for the doctor.
Set the priority and the times
In Triage, choose the Mode of arrival and a Priority from Blue — non-urgent to Red — immediate, and write the Chief complaint. Type the Time of arrival, Time of assessment and Time of decision; OPALEVI works out the Wait until assessment and the Total stay in minutes.
Survey, treat, survey again
Under Primary survey (ABCDE), mark each letter under First assessment, then again under Reassessment. Score the Glasgow Coma Scale (GCS) and tick the Interventions performed.
Pin the injuries
Mark each wound on the Injury map with its Type of injury, and any burns on the Burns map.
Decide and hand over
Under Decision, choose the Conclusion, from discharged to a ward, theatre or a transfer, and write the Handover notes. For a patient going home, fill in Instructions for the patient and Come back or call for help if under Discharge and instructions.
Who writes which part
By default a nurse prepares the visit and the treating clinician writes the record, triage included. Where nurses triage, give the Nurse role Write the clinical record under Settings → Roles and finances. Each block shows who wrote it and when, and Change history keeps every save, before and after.
Plainly put: the times are typed, as on a triage card, not stamped by a button. And OPALEVI does not triage: the colours are unnumbered categories your clinicians choose, with no target time and no suggestion from the vital signs.
Injury and burns maps, and the numbers OPALEVI adds up
Which numbers does OPALEVI work out for you?
The waits
Wait until assessment runs from arrival to assessment, Total stay from arrival to the decision. A span past midnight counts into the next day; past twelve hours the form shows Check the times — more than 12 hours. Neither figure is stored.
Consciousness and early warning
OPALEVI adds the GCS eye, verbal and motor scores into a total from 3 to 15, with the University of Glasgow's credit. The NEWS2 — early warning score is scored on the Royal College of Physicians' chart and its total typed in. What a score means stays the clinician's call.
Burns and the TBSA
Each area on the Burns map has a Burn depth and a Body surface burned percentage. Total body surface area burned (TBSA) adds them, leaves out areas marked Superficial (epidermal), and warns when the sum passes 100%.
The percentages are yours
OPALEVI does not measure a burn from the drawing and has no rule-of-nines or Lund and Browder chart. Estimate each area with your department's chart; the program adds them up and calculates no fluids.
After the decision: a bed, a theatre or another department
In a hospital the conclusion adds a ward, intensive care, theatre and a transfer to the outpatient answers, and leaves out “Referred to hospital”. Choosing one books nothing by itself: the bed and the theatre are separate steps.
Patient rooms shows every room with its beds, who is in each, since when and why. Admit patient takes a free bed, the patient and, for an Acute stay, a reason such as Observation; today's visit is linked to the stay automatically, as long as it has not been finished. The stay page offers Move to another bed and discharge, and At the bedside shows allergies and blood group.
On Operating theatres, Add operation books a theatre for a time, with the surgeon and the patient, and refuses a double booking. The ward that follows is covered in our guide to surgery and ward software.
Refer to a department sends a routine or urgent request to another department's worklist, for a consultation, imaging, a laboratory analysis or a procedure. See radiology software for the imaging side and cardiology software for a chest-pain patient's next stop. Where the laboratory runs in OPALEVI, results open from Analysis results.
What the patient and the next team take with them
An emergency visit has four print buttons: Print prescription, Print referral letter, Discharge and handover summary and Report, each drawn from the saved visit under your letterhead.
The Discharge and handover summary is one paper for two readers: arrival, vital signs, survey, injuries, what was done and given, the decision, then the handover notes or the instructions and return signs. Empty sections are left off, and the triage colour is not printed: it is the department's working category, not part of the patient's paper.
For a note in your own wording, Discharge notes keeps a register: Issue a discharge note from a Template, then edit it. The text is copied at issue and Finalise locks it; a correction is a new note. If the menu is missing, switch it on under Settings → Application menus.
If the patient must come back, Book a follow-up appointment opens the calendar on him, and he can be emailed a reminder the day before. Invoice this visit copies the visit's services into an invoice at the prices recorded.
Questions to ask before choosing emergency department software
Ask these of every program on your shortlist. OPALEVI's answers include a plain no.
| Ask | Look for | In OPALEVI |
|---|---|---|
| Does the record follow the first hour? | Arrival, priority, times, survey, interventions and decision together. | Yes: the Triage section. |
| Are the waits calculated? | Durations from the recorded times. | Yes; the clock times themselves are typed. |
| Are first assessment and reassessment apart? | Two columns. | Yes. |
| Which scores add up? | A clear line between calculated and entered. | GCS adds up; NEWS2 is typed. |
| Is the burned surface totalled? | A depth per area, superficial burns left out. | Partly: percentages are typed, then added. |
| Does it fit your triage scale? | Your protocol's categories. | Partly: five unnumbered colours, no flowcharts. |
| Can you see who waits, by priority? | A waiting board sorted by category. | No: the Departments board shows visits and status only. |
| Can nurses write the triage? | The person who triages, under their own name. | Yes, once the Nurse role has Write the clinical record. |
| Does an admission reach a bed? | The emergency visit linked to the stay. | Yes, while the visit is still open: Patient rooms. |
| Will more beds raise the bill? | A charge tied to the team, not to cases or rooms. | No: OPALEVI counts staff members, never patients, beds or departments. |
Every module is on the features page. For a buying checklist that covers the whole practice, read how to choose clinic software.
Your first week in the emergency department
Register as a hospital and choose Emergency among your departments; rooms and theatres start switched on. Then, besides the First steps checklist on Today:
Price the department's work
Add its services, so a visit is billed on the day it happens.
Head the paper
Set up the report letterhead used by every summary and report.
Build the rooms
Add the observation room and the wards, each with its beds.
Invite the team
Add the doctors, nurses and desk, decide who triages, and draft templates for your two most common discharge notes.
Run one shift beside your card
Record one real shift in OPALEVI beside your usual triage card, then compare the waits, handovers and papers. No demonstration tells you as much.
Frequently asked questions
What is emergency department software?
It is software built for an emergency department's work: it records each case from arrival to the decision (triage category, times, observations, primary survey, interventions) and passes it on to a bed, a theatre, another department or home, with the papers the patient and the next team need.
Does OPALEVI triage patients?
No. It records the colour your clinician chose, from Blue — non-urgent to Red — immediate; it runs no triage flowchart, suggests no category and sets no target time. It does calculate the wait until assessment and the total stay from the times you type.
Can reception see emergency clinical notes?
The hospital decides. The desk can register patients and open visits without reading the record, and its access to clinical history is a single switch. Each department's record privacy can also limit records to its own staff or to the treating clinician.
Does it work on a phone or a tablet?
Yes. The hospital uses the web browser on the computers, tablets and phones it already has, and nothing is installed. On a phone a bottom bar replaces the top menu, and a hospital nurse's phone opens on the patient rooms, to check a free bed from the corridor.
Can I try it before paying?
Yes. Registering the hospital opens a free trial, and no card is asked for. If no plan has been chosen by the time it ends, nothing is charged: the account turns read-only and keeps everything recorded in it, including the shift you tested on.
What does OPALEVI cost a hospital?
It is charged per staff member using it, monthly or yearly. Patients, beds, departments and locations are never counted, so a new emergency department adds only the people who work in it. The pricing page has the figures and a calculator.
