TY - JOUR T1 - Highlights from this issue JF - Emergency Medicine Journal JO - Emerg Med J SP - 861 LP - 861 DO - 10.1136/emermed-2012-202015 VL - 29 IS - 11 AU - Darren Walter Y1 - 2012/11/01 UR - http://emj.bmj.com/content/29/11/861.abstract N2 - Is the ED busy? We all ‘know it when we see it’, but Beniuk et al report on a Delphi to determine metrics that can quantify the level of crowding. The eight consensus parameters are no surprise; they seem to mirror the performance reporting that is currently required of us in the UK. The interesting bit is that this comes from an international panel; perhaps we ARE looking at the right things (see page 868). When we are busy, the error rate rises. When we are interrupted, the risk increases further. Allard et al report on a simple observational project around the role of an emergency consultant ‘on the floor’; the type and frequency of interruptions and the effect on efficiency. Analysis of a single person in a single environment so comes with a health warning, but it does make you think (see page 872872). To handle patient surge, we rely on systems and processes; but are they safe? Can patients be safely streamed to Primary Care from ED triage using our current systems? Van-der-Straten et al suggest that … ER -