SainteMarie Emergency Department Case
1. Some of the operational problems that Saintemarie Emergency Department is facing include issues with quality, work environment and economic issues, amongst others. In terms of quality, the wait-time targets are being met, however, a doctor sees only 2/3 of patients that enter the emergency department within the maximum delay period. This means that the quality of service suffers as well as patient safety for those that leave without seeing a doctor due to long wait times. As far as work environment issues, the department is struggling because experienced nurses and doctors are resigning since the environment seems to be too stressful. Lastly, Saintemarie ED is facing economic issues because the long wait times are having negative effects on revenues since there are lost revenues associated with patients leaving and not being treated.
The current performance of the emergency department is not up to standards and would receive a grade of a 6 out of 10 if it had to be ranked on a great performance scale. Some of the drivers of these problems include the fact that the emergency department is the only one
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If we were to conduct a back-of-the-envelope calculation on the average time that patients wait before entering the care process, it would result in approximately one hour for the average time. We can calculate this by adding the time it takes for the nurse to perform the triage (about 2-3 minutes), plus 10 minutes for the administration entry (registration). Then we need to average out the amount of time it takes to for someone to be assigned based on the different degrees of emergency. I.e. the first degree is immediate (zero minutes), the 2nd degree wait time is approximately 20 minutes, and the third degree average wait time is about 120 minutes (2 hours). If we take the average of these three we get approximately 47 minutes and we can add that onto the 12-13 minutes prior to get an average wait time of about one
De Tar Hospital should ensure that EMTALA compliance is monitored regularly through internal auditing of emergency department records. Issues identified should be examined against existing policies and procedures to determine whether the problem is an isolated error which may be corrected through education and discipline, or if there is a more systemic problem that calls for major modification of existing policies and procedures. For example transfer records executed by Dr. Burditt and other physicians should be reviewed see if there is a pattern of inappropriate transfers by other physicians or if this is just an isolated incident. Such a proactive approach to addressing EMTALA compliance issues should significantly reduce the hospital’s liability for violation.
2. In recent years, there has been a growing attempt to measure the performance of health care providers. The federal government and the states have published data on how hospitals are compared to acceptable clinical standards with regard to pneumonia. Explain how these data could affect the consumer decision-making process.
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
There are pros and cons. Some medical people believe that the EMTALA legislation creates some problems for hospitals. Knowing that hospitals must take care of every person, people may use the ED for routine doctor visit situations. These people believe this contributes to the sometime overcrowding of ED’s. Another problem is that EMTALA legislation mandates caring for everyone no matter what. The hospital therefore, may not get paid. “According to the American College of Emergency Physicians, 55 percent of emergency care goes
Government has developed ‘Star Ratings’ system which monitors improvements in accountability measures. The experience of the ‘Star Ratings’ system in respect of service efficiency indicates that it is prudent to act pro-actively rather than re-actively. It is vital to consider that the Government is expecting demonstrable improvements in health services rather than rhetoric alone (Radnor and Lovell, 2003).
In order to properly address the issue and look for a remedy, it is necessary to understand the underlying conditions that create the problem before creating the means to manage the change required to correct the problem. The Crowded Clinic has multiple issues, including social and operational, which are creating the associated inaccessibility to services. The
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.
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.
V ́ericourt, F., & Jennings, O. B. (n.d.). Nurse-to-patient ratios in hospital staffing: a queuing perspective. Retrieved from https://faculty.fuqua.duke.edu/~fdv1/bio/ratios3.pdf
The purpose of this case study is to investigate and bring new insight to situations and behaviors within an organization. Case studies are learning tools which utilize social science research to identify and resolve individual and organizational challenges (K. Mariama-Arthur Esq., 2015).
Poor staffing stresses every nurse and makes them despite what they once loved to do. Nurses are overworked and because of that they may not provide adequate patient care.
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...