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 …show more content…
The first thing is having a fast track unit where lower acuity patients are seen. Lower acuity patients can take up rooms and staff on the main side emergency department, which in turn can cause longer wait times for higher acuity patients in my experience. The second thing that I believe can improve patient flow is having physician assistance or nurse practitioners who can see the lower acuity patients, which in turn allows the physicians to be able to focus on higher acuity patients. The third thing that I believe can help improve patient flow in the emergency department is a discharge team who can solely focus on reviewing results when they are available and getting patients quickly discharged as soon as possible. I definitely believe these three things could greatly improve the major issue of patient flow in an emergency …show more content…
87). This study took a quantitative approach to show how the implementation of a fast track unit operated by a physician assistant could help to improve wait times for all acuity patients and improve length of stay for lower acuity patients (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 87). There is a literature review under the heading of introduction included in this article and a theoretical framework is also present; however, most resources that were cited are greater than 5 years old (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 87-88). Experimental design was used with this study since it examined the implementation of the fast track unit and then evaluation of the effects it had on wait times and length of stay (Keele, p. 41). A power analysis was used to determine sample size needed to show changes of 15 minutes or more in length of stay and wait times (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 89). The extraneous variables are number of complaints, mortality, acuity level, and presence of complex problems (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 88-89). The data was collected from the E-care automated information system for emergency departments (Theunissen, Lardenoye,
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
Without question the cost of medical care in this country has skyrocketed over the last few decades. Walk into an emergency room with an earache or the need for a few stitches and you’re apt to walk out with a bill that is nothing short of shocking.
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.
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
The Crowded Clinic Case Study (Colorado State University - Global, n.d.) discusses the issues of practice management as they apply to access to care. Access to care may be as inconvenient as lengthy patient wait times to issues far more serious that may have a profound effect on the health and well-being of a single patient or an entire cohort.
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.
Three departments that will have the most impact on VBP in our organization are Nursing, Emergency Department (ED) and Intensive Care Unit (ICU).
nurses are quite busy especially with another patient of a high acuity and have no time to
When I arrived SB was in bed asleep. I woke SB up to give SB her medicine, SB received her 7 AM, 9 AM medication and eye drops. Around 10:10 Sheila informed me she was dizzy and needed to use the rest room. SB attempted to get up and to use her walker. SB made it to the hallway and was not able to walk anymore because her walker's back wheel was not working. I assisted SB to the bathroom. When leaving I had to catch SB a few times. I called the emergency line because Sheila was saying she was dizzy and her walker was not properly working. At 11:52 AM I was assisting SB out from the bathroom and I went back into the bathroom to clean up after her. While I was in the bathroom, I asked SB a few times if she was fine and needed any help. I heard
Also, these studies question those who are effected; in this case, those who are most effected, is everyone. Doctors and nurses spend the most time working within these systems, but the information that is put into these systems effects every individual in America, because it is their information. Because nurses are often considered “both coordinators and providers of patient care” and they “attend to the whole patient,” their opinion is highly regarded (Otieno, Toyama, Asonuma, Kanai-Pak, & Naitoh, 2007, p. 210). It is clear that the use of these new systems is much debated, and many people have their own, individualized opinion. This information suggests that when there is a problem in the medical field, those who address it attempt to gather opinions from everyone who is involved before proceeding. It has been proven by multiple studies that this system of record keeping does in fact have potential to significantly improve patient health through efficiency, and it is because of this that the majority of hospitals have already completed, or begun the transfer from paperless to electronic (Otieno, Toyama, Asonuma, Kanai-Pak, & Naitoh,
The cost of Medical equipment plays a significant role in the delivery of health care. The clinical engineering at Victoria Hospital is an important branch of the hospital team management that are working to strategies ways to improve quality of service and lower cost repairs of equipments. The team members from Biomedical and maintenance engineering’s roles are to ensure utilization of quality equipments such as endoscope and minimize length of repair time. All these issues are a major influence in the hospital’s project cost. For example, Victory hospital, which is located in Canada, is in the process of evaluating different options to decrease cost of its endoscope repair. This equipment is use in the endoscopy department for gastroenterological and surgical procedures. In 1993, 2,500 cases where approximately performed and extensive maintenance of the equipment where needed before and after each of those cases. Despite the appropriate care of the scope, repair requirement where still needed. The total cost of repair that year was $60,000 and the repair services where done by an original equipment manufacturers in Ontario.
Accidents, injuries, and illnesses are unpredictable and they can occur within the blink of an eye. If an unpredicted injury, accident, or illness occurs after-hours, you won’t have instant access to your family physician. And, depending on the severity of the problem, you will have to rationally decide what actions are needed to help with pain, sickness, or other symptoms you are experiencing. When people experience an accident or injury, in most cases their first thought is to head to the emergency room. However, going to the ER for certain injuries may not be the best solution available.
“The Aravind Eye Care System has dramatically improved the quality, volume and efficiency of eye care delivery in India and inspired health workers everywhere.” (Brilliant, L & Brilliant, G. (2007)) The workflow of doctors are set high, they perform over 200,000 surgeries per year. Keeping the waiting time between each operation very small and steady, resulting in many more patients becoming operated on. “The second core principle is excellence in execution of ensuring a high level of efficiency in providing the treatment, including outpatient services and surgeries.” (Tikoo, R. Financial Express). The gap between each operation was so precise and consistent; it solely helped improve the efficiency of the hospital. “By the time the first operation was finished, the second patient already had a microscope focused on their eye. Dr. Aravind then moved straight to table no.2 without any interlude.” (Manikutty, S & Vohra, N
My overall learning experience during my preceptor shifts was amazing. The first day I walked into the Emergency Department for my shift, I was having anxiety through the roof and very nervous. I felt like I did not know anything and it was a completely new environment then I am use to. At this point I feel very comfortable in the environment and felt like I have gained the knowledge to be a competent nurse in practice. I owe a lot of the success I have had in the ED to my preceptor Sam. He was seriously great and very patient with me when I was trying to learn something. He really pushed me every day to be confident and comfortable taking care of patients on my own. I have gained a vast knowledge of skills, procedures, policies, documentation,