Improving “waiting Time” in the Emergency Department
According to the Centers for Disease Control and Prevention (CDC) (2012), the average time patients spend in the U.S. emergency department (ER) before they can see a doctor has increased to 25% between 2003-2009. The main cause of longer wait times (WT) in the ER is overcrowding. Overcrowding has been found to be closely related to both subjective and objective patient satisfaction (Miro’ et al, 2003). Longer wait times in the ED is such an important issue because its consequences are detrimental not only to the ER patients, but also to providers. As a health care provider, decreasing patients’ WT in the ED is essential, although challenging, to improve patient’s health outcomes and increase patients’ satisfaction. Although it is a very challenging issue to tackle, hospitals that have initiated some quality improvement (QI) strategies are experiencing some positive outcomes in that area of care. The outcomes are measured by decreased waiting times, improved patients’ clinical outcomes and increased patients’ satisfaction.
The purpose of this paper is to investigate on the issue of longer waiting times in the ED. The body will use live experiences of daily practices relevant resources to substantiate the following ideas by: stating the general background or the prevalence of long waiting time in the ED and to describe previous attempts (interventions) used by healthcare institutions to solve these chronic waiting time issues.
Causes of longer WT in the ED
Research holds that major precipitating factors of longer WT are overcrowding defined by Paul, Reddy & De Flitch (2010) as a serious threat to healthcare system that has reached the crisis proportions in the United State...
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... 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.
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
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
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.
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Patient waiting times and waiting-room congestion in outpatient settings are two challenges facing the healthcare industry. Survey results indicate that excessive waiting time is often the major reason for patients' dissatisfaction with outpatient services. Waiting times of 10 to 15 minutes are considered reasonable.
The issue of off load delay is becoming ever more relevant as emergency departments (ED) are filling up and having longer wait times. This isn’t always an issue when there are free paramedic crews in the area but it often results in coverage lapses. The question becomes, should paramedics be leaving their less urgent patients in triage with walk-in patients so that they can get to other people in need? A balance needs to be found between leaving the CTAS 4 and 5 patients in the waiting room and leaving 911 callers at home to wait.
Beneficence is our moral obligation as nurses to embrace the patient’s well-being, opposing this principle of only doing good for patients are hours of delays. Emergency Departments experience access-block and sub-optimal patient outcomes as a result of delays. Emergency departments are
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Sayah, A., Rogers, L., Devarajan, K., Kingsley-Rocker, L., & Lobon, L. F. (2014). Minimizing ED Waiting Times and Improving Patient Flow and Experience of Care. Emergency Medicine International, 2014, 1-8. doi:10.1155/2014/981472
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Rationale: I feel that wait times in the ER have become a bit of an argument. Experiencing this problem from both sides of the issue I feel that this topic is one of great interest for me.
The health care system is plagued with many problems and one of the most prevalent problems is staff shortages coupled with decrease in medical and financial resources (Swayne, Duncan & Ginter, 2008), Children’s...
In today's health care environment many factors contribute to quality care. As a medical practice manager it is important to provide the best medical service for patients in addition to excellent levels of service. Appointment scheduling is a very important aspect of a smooth running medical practice. Appointment cancellation, no shows, and long waiting time by patients have a negative impact on the efficient running of the practice not only in lost revenue but the practices professional reputation as well (Kruse 2010).
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