Analysis and Use of the Management Cycle

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

Implications on Healthcare System: The general misuse of the Emergency Rooms as a replacement for patient’s primary care can be considered one reason why hospitals on Marcus Island represent the biggest hurdle with regards to healthcare cost containment. Patients are likely to use the ER for primary care because they know they will be seen on the same day at the ER, versus the potential wait time of 2-4 weeks to get an appointment to see their primary care provider. Inappropriate ER use is expensive for hospitals, and prohibits continuity of care for patients.

Once you arrive at the emergency room, you experience more waiting depending on your current condition. Some of these waits depend on: length of stay, time waiting for assessment, condition, waiting for inpatient bed, and lack of resources. Finally, when you’re ready to leave the emergency department waits can occur, like waiting for an inpatient bed or a ride home (CIHI, 2012). All of these reasons impact the growing wait times, with older adults becoming more frequent in emergency departments and the increasing population of older adults these wait times are going to continue to grow causing more harm than good, if older adults are unable to receive the appropriate care in a timely matter (Cooke, Oliver, & Burns, 2012).

Emergency departments are considered an important aspect of the health care system. For many years, wait times have been an area of concern for many Canadians and remain a significant issue. One of the major concerns within the Canadian health care system is the amount of time spent as waiting time in the healthcare services. Wait times are the length of time from when the patient is triaged and registered, to when the patient leaves from the emergency room (Affleck, Parks, Drummond, Rowe, & Ovens, 2013). Whether waiting for a doctor, waiting for prescription medication, or even waiting to get tested, the reasons for wait time in Canada are caused by many factors (Cole, Hopman, & Kawakami, 2011). This paper will seek to examine the factors contributing to longer wait times in the emergency department, examine the ways in which wait times impact society, and conclude by presenting possible solutions to reduce wait times.

In 2000, the Department of Health(DH), set a range of emergency care access targets in its NHS plan, and in 2001 the government published Reforming emergency care   (DH, 2001) which established waiting time targets for all UK emergency care patient contacts;. The new standard was introduced into the NHS in England in 2002; stating that 98% of patients presenting to ED’s would be seen, treated, admitted or discharged within four hours of arrival by 2004, no one was to wait more than four hours in an ED (from arrival to admission to a bed, transfer elsewhere or discharge). Whilst the author agrees that it has improved the overall for the patient’s experience within the ED. It must be borne in mind that before the decision ‘to come into’ hospital (TCI), that the patient receives the correct clinical decisions prior to TCI.

Assess the current Models of Care in their Emergency Departments using the given criteria It is recognised that not all of the Models of Emergency Care are applicable for all NSW Emergency Departments. Decisions to implement them will be made based on the staff, patient presentations and space available in the ED to operate each model. Assess the potential to introduce models to their hospitals that may improve patient care and flow, the patient experience and clinical outcomes

We all know that communities are as unique as the people who live in them, and because of this, we must realize that the fire departments that serve these communities must be unique as well. Likewise, there is no cookie-cutter formula for what type of fire department best suits a community, for there are many factors to take into consideration. For example, the size of the community, the economic stability, and service demands of the community; and depending on these, a community may be adequately protected with a volunteer, combination or professional department (Brunet, DeBoer, & McNamara, 2001).

“Long wait times could potentially result in worse patient outcomes, greater patient suffering, patient dissatisfaction, more difficulty retaining and recruiting staff, a higher risk of infectious disease outbreaks and an increased risk of medical errors” (Ducharme, Alder, Pelletier, Murray, & Tepper, p. 456). This article explored how the addition of nurse practitioners and physician assistants in 6 Ontario emergency departments could help to reduce wait time, patient flow, and the number of patients who left without being seen (Ducharme, Alder, Pelletier, Murray, & Tepper, p. 455). This study was seen to be the first of its kind in analyzing effects in an emergency department on patient flow by adding nurse practitioners and physician assistants to the healthcare team (Ducharme, Alder, Pelletier, Murray, & Tepper, p. 459). The quantitative study design used for this study was the experimental design since it was based on implementation and evaluation of the effects (Keele, p. 41). The article does not address how the sample size was determined and actually

Today’s society has seen an increase of unpredictable violent events that require an increasing need for tactical medical responders. While some if not all departments in the United States have a form of Tactical Emergency Medical Support, in the present time it almost seems as if there is a growing need for awareness, education, and personnel to have a tactical mindset. Tactical Emergency Medical Support is an out-of-hospital EMS system that focuses on medical support for law enforcement special operations missions. Although most emergency situations involve routine-like situations such as a mild allergic reaction or a person going in to cardiac arrest, Emergency Medical Responders need to be prepared for the unexpected. Multiple

In response to this the government introduced the fast track systems which was aimed at reducing wait times within ED. But “Have fast-track systems in Emergency departments been effective in reducing wait

This report set provides metrics on utilization of care performed across the organization for Emergency Departments, and enables trending of ED utilization and cost over time to uncover addressable insights. It is normalized per 1000 beneficiaries.

This article is about wait times, and how this urban hospital was able to reduce wait times, and increase quality of care and the hospitals scores. By implementing a rapid assessment (RA) and keeping registration after the nurse, and physician assessments were completed it helped improve door to physician time, and kept the flow going in the emergency department.

The Commonwealth Government previously funded the change management and ongoing financial incentives for the National Emergency Access Target (NEAT) program. However, this funding is threatened as a result of the proposed reform. The NEAT program, which was introduced in 2011, established a national priority that the majority of patients presenting to emergency departments should be treated within four hours. This was in response to evidence that prolonged length of stay resulted in increased mortality.(14) Over time, improvements in NEAT compliance rates have demonstrated the intended beneficiaries.(15) The aim of the program was to incrementally increase the target such that 90% of all emergency department presentations were within the ‘four-hour rule”; however, funding cuts since the introduction of the program have stalled the progress. This is likely to be further hampered through the proposed

Over the last several years, hospitals have been dealing with an increase in the total number of patients. This is because a larger percentage of people are living longer and there is more demand for these services. As greater amounts of the population is reaching the age of 65 and beyond (i.e. the Baby Boomers). This is placing strains on existing facilities to meet the needs of patients. The results are that health care providers and professionals are becoming overworked. This is leading to reduced response times. (Giganete, 2010) (Dowd, 2012)