The goal in all healthcare settings is to provide high-quality care to their clients. Emergency departments (ED) are no different, but are challenged with balancing quality with quantity in a timely manner. Unlike physician offices and hospital floors, EDs do not get to set a limit on the number of patients they see at a time. There is no control over patient arrival, which can and often does result in controlled chaos. The American College of Emergency Physicians (2014) reports “because of the unscheduled and episodic nature of health emergencies and acute illnesses, experienced and qualified physician, nursing, and ancillary personnel must be available 24 hours a day”. Despite the unpredictable nature of emergency medicine, the goal …show more content…
We also have maintenance workers that double as security at the main ER. The pre-hospital emergency services work as an extension of our ERs. They transport patients to and from the ERs, and assist in facilitating quality care to the patients in our communities. For instance, they have the capability to send a 12-lead ECG via fax to the ER to notify of a ST-segment elevation myocardial infarct, often allowing for door to cath lab time to be less than 10 minutes. The main ER also has access to a trauma team, which is a team of hospital staff, including the house supervisor, Intensive Care Unit charge nurse, surgeon, respiratory therapist, lab technician, radiology technician, and chaplain that respond to any moderate or major trauma. Our specialty physicians include orthopedists, pulmonologists, neurologists, pediatricians, cardiologists, psychiatrists, gynecological /obstetricians, otolaryngologists, pain management, hematology/oncologists, and interventional radiologists. Neither ER has full time housekeeping, so the nurses and PCTs are responsible for cleaning rooms and keeping the department clean. Housekeeping is only responsible for cleaning rooms that require specialized treatment, such as isolation
Monitoring staff levels is an important factor. Also leveling the flow of patients in and out institutions could help to reduce wide fluctuations in occupancy rates and prevent surges in patient visits that lead to overcrowding, poor handoffs, and delays in care. Studies show that overcrowding in areas such as the emergency rooms lead to adverse outcomes, because physicians and nurses having less time to focus on individual patients. One study found that for each additional patient with heart failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of readmission increased between 6 percent and 9 percent (Hostetter and Klein, 2013). All of which costs the hospital money.
The challenges that all acute care hospitals and facilities faces are the demand for highly specialized services has increased. The US population is constantly aging and the elderly tend to need more acute care services. Because many people lack health insurance, they tend to use emergency rooms in the hospitals as their source of care. The increase demand in acute care prompted hospitals to expand their facility
I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
Based on the data from Hospital Compare two of the measures that need some improvement are the patient experience and timely effective care, particularly the emergency department. These two measures are associated with the quality dimensions of timeliness and patient centerness. Timely and effective care can play
Because of the lack of organization with the health care providers in Canada, the wait times are too long and can cause serious complications to any condition the patient went in for in the first place. This situation of how the health care system can resolve wait times was brought to the government but they continue to ignore the proposals brought to them. It is possible to resolve the problems of wait times without extreme change and expenses in the health care system. The solution is to be found in the reorganization of the health care providers. Lack of assistance in the emergency room can make ones illness to become worse, therefore, causes the patient to be forced to wait in emergency rooms for an extended period of time and when they are finally seen by a health care provider, the outcome is very poor due to lack of registered staff, physicians and proper assessment(Goldman & Macpherson, 2005, p.40). The objective of this paper is to discuss and critically analyze the conditions of emergency waiting rooms. The specific issue this paper intends to explore is extensive and prolonged waiting times for patients accessing health care, patients who need urgent treatment and the vulnerability of elderly patients and children. With an in-depth critique of the barriers to health care and shortcomings of emergency rooms, strategies will be provided to enhance a health care system that makes it more accessible and efficient.
I believe that if you asked a group of people to list off issues regarding an emergency department then they would say long wait times throughout the process and being moved around to different areas of the emergency department. From what I have heard the long waits can be associated with waiting to get back to a room, waiting to see a nurse, waiting to see a doctor, waiting to go to radiology or lab, waiting on results, waiting to be discharged, or waiting to be admitted. All of these things in my opinion add up to one main problem, which is patient flow through an emergency department. In my opinion being able to have a controlled patient flow allows for improved wait times and decreased chaos for patients. So there are a few things
Pham, J. C., Seth, T. N., Hilton, J., Khare, R. K., Smith, J. P., & Bernstein, S. L. (2011). Interventions to improve patient-centered care during times of emergency department crowding. Academic Emergency Medicine, 18(12), 1289-1294. doi:10.1111/j.1553-2712.2011.01224.x.
Wake County EMS responds to almost 90,000 requests for service annually and serves almost 1 million people, which places the WCEMS system in the top fifty EMS systems in the country based on call volume and size of population served. ("Wake county department," 2012) In response to ever-increasing call volume, a decrease in primary care, and the universal changes in healthcare, which have resulted in more people using EMS and the local emergency room for primary care and non-life threatening events, the EMS Department elected to change their service structure. The department would move away from the traditional EMS mantra of “you call we haul” and having a system being designed around reactive responses to healthcare issues in the community to an evidenced based incident prevention structure. No longer, would it be considered prudent or correct to just continue to add transport resources to address the increasing call volume and continue to place the actual burden of care on the local hospitals, it would become the burden of the EMS system to provide alternatives to properly address the actual healthcare needs of those who called 911. Wake County EMS had already utilized evidenced based ...
Under the Emergency Medical Treatment and Labor Act of 1998 (EMTALA), health providers by law are supposed to follow the federal guidelines and the EMTALA when you work in an emergency medical care at certain hospitals (facilities that participate in Medicare-includes 98% of hospitals in the United States (U.S.)). This also means that any part of the hospital that can perform an evaluation and treatment of EMC is considered an ED., for example, a women's hospital that delivers babies is subject to EMTALA. As a health care professional under this law, you have to make sure that every person entering a hospital in need or requesting receives a medical screening examination (MSE), and an emergency medical condition (EMC) evaluation to determine
... revealed that longer waiting times has negatively impacted the lives of not only patients, but also healthcare providers . Some QI strategies implemented such as simulation tools, fast -track and reorganization of the ED by several hospitals has shown some improvement in workflow thus decreasing overcrowding and the length of time spent in the ED. As healthcare leaders, the focus should reside on ongoing advocacy for new policies or guidelines to resolve the waiting time issues and addressing limitations of previous interventions. Addressing the ED issues, Leaders should abide by the IOM report considering overcrowding as a mostly external or a system-wide issue. Implementing preventive measures described earlier will help not only to decrease WT in the ED, but also to avoid future incidents similar to the one recently experienced in St Barnabas Hospital.
The film, The Waiting Room, paints a clear picture of the variety of obstacles that commonly occur in the emergency department. The majority of patients are uninsured, are using the hospital as their primary care physician, long wait times and communication challenges. This paper will outline challenges displayed in the documentary paired with different ideas working to create a more effective health care experience.
Nevertheless, when patients arrive at the A&E Department, a trained triage nurse will help determine the relative priority due to the patient's condition. There are five categories for nurses to classify, such as critical (immediate treatment), emergency (waiting time within 15 minutes), urgent (waiting time within a half hour), semi-urgent and non-urgent. Yet, it trend to treat the triage nurse as a McDonald’s Customer Service Ambassador in charge of the system carries out smoothly and conveniently. Apart from that, specialist out-patient clinics also have the same problem. In general, patients visit general out-patient clinics or private family doctors which make referrals due to special cases.
Emergency room physicians are on the front lines in a crisis, caring for everyone from trauma victims to sick kids. An ability to think quickly and care for a wide variety of patients makes them valuable assets at every hospital. It also brings some perks. When sudden illness or acute injury strikes, patients turn to hospital emergency rooms for immediate medical assistance. An ER doctor, or emergency medicine specialist, is a physician who diagnoses and treats illnesses and injuries in a hospital emergency room or other urgent care setting. Emergency medicine is a financially rewarding career, and it also comes with the reward of saving lives. ER doctors require intensive training to know how to shoulder their intensive responsibilities.
Emergency is defined as a serious situation that arises suddenly and threatens the life or welfare of a person or group of people. An emergency department (ED) or also known as emergency room (ER) is a department of a hospital concentrating in emergency medicine and is accountable for the delivery of medical and surgical care to patients arriving at the hospital needing an immediate care. Usually patients will arrive without prior appointment, either on their own or by an ambulance.
Commonly throughout most countries of the world, citizens of the society at large establish the system for Emergency Medical Services. In the case that the public is not willing or capable of summoning such a service, the country often finds other emergency services, businesses, or the government and authorities who act to employ a system. In other parts of the world, the emergency medical service additionally takes on the role of transporting patients from one medical facility to an alternative one. This occurs with some frequency because once a patient is analyzed and provided care at the immediate hospital; it may be more appropriate for a variety of reasons the patient needs to move to another facility. As one can see, the relat...