Short Communication: Improving Timeliness of Analgesia for Acute Trauma-Related Pain in the Emergency Department Green Zone — A Quality Improvement Initiative

Abstract

Background: Emergency Department (ER) overcrowding is a perennial issue in Malaysia. Non-critical, lower-acuity patients in the Green Zone often face long wait times, which frequently leads to institutional oligoanalgesia (delayed or inadequate pain relief). Objective: This short communication outlines a Quality Improvement (QI) work flow proposed by the author to clear departmental bottlenecks. The main target is to bump up the percentage of Green Zone patients with acute trauma-related pain who get their pain relief within 90 minutes of registration. This framework serves as a suggested model for other public hospitals looking to improve their ED throughput. Methodology: Using the Nominal Group Technique (NGT) and SMART prioritization criteria, the author evaluated key departmental issues and selected delayed pain management as the priority target. A strict Model of Good Care (MOGC) was designed to run through a rapid implementation timeline from July 2026 to August 2026. Data collection plans include pulling timestamps from the Electronic Health Record (EHR) system and handing out targeted questionnaires to frontline staff. Expected Outcomes: By sorting out the fragmented department layout, introducing decentralized analgesia sub-stores/carts directly inside the Green Zone, and conducting proper staff briefings, this model establishes a practical, sustainable work flow to hit our national KKM QA benchmark of ≥ 70% compliance.