Crowding In Health Care

looking at mortality rates in patients seeking emergency care conclude that the rate of death is substantially higher during times of crowding (Richardson, 2006, p. 213).

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

The emergency department is a general point of entry to a hospital and most frequently visited by those in need of an urgent care issues. The patient’s wait time begins from the moment the patient walks into the emergency department and end by the time the patient leaves the ED. Longer wait time might lead to crowding, complications and distress to the patient and can negatively impact the organization overall quality, financially, and patient relation among other implications. Some of

The implications and effects on patients waiting long hours to be seen in the ED are immense. In a recent study done over five years in Ontario hospitals showed the risk of adverse events and even deaths increased with the length of stay in the ED (Science Daily, 2011). When EDs become overcrowded the quality of care changes and declines; which is extremely dangerous. Authors of the study calculated that if ED length of stay was cut by only an hour that 150 fewer Ontarians would die each year (Science Daily, 2011). Wait times can also negatively affect patients financially, untreated medical conditions can lead to reduced productivity and inability to work leading to increased financial strains (Fraser Institute, 2014). As well as delayed access to care can result in more complex interventions needed. Therefore an initiative is needed to provide patients with timely, efficient care when accessing

First of all, ED overcrowding has a significant negative effect on patient safety and quality of care. According to….., for patients judged by the triage nurse to be critical, more than 10% waited more than 1 hour to see a doctor. This is dangerous, because many illnesses are time dependent. Late diagnose might result in delays in the treatment and cause permanent consequences of disability or death. High occupancy in one Australian ED was estimated to cause 13 patient deaths per year. Another study examined the complication rate among patients with acute coronary syndrome and found a significant increase in serious complication in patients seeking emergency care during times of crowding. Patients and their accompanying family or friends may also have greater exposure to hospital-acquired infections during prolonged waiting time.

This research is trying to answer the question of how to reduce overcrowding in emergency rooms? Would people would want to access published wait times provided on the internet, and would this guide a patient make decisions on where they receive their care. The hypothesis being one, crowding maybe reduced with having upfront information, and therefore also provide increased patient satisfaction due to waiting less. Patients would have more choices available to them such as

Tang N, Stein J, Hsia RY et al: Trends and characteristics and US emergency department visits, 1997 – 2007.  JAMA 2010; 304: 664-670

Emergency departments are facing a shortage of trained nurses that are capable of functioning in the fast-paced environment such as an emergency department. The problem is the emergency room is not retaining nurses and faces a continuous influx of untrained, new nurses to fill the void. This unstable staffing situation leads to hazardous care environments for both patient and nurse. This is a perpetual the cycle that worsens with time and becomes a viscous cycle of departure. The nurses who stay become fatigued, overwhelmed and burned out, which causes more nurses to leave. The nurses who remain face short staffing, the burden of training new hires without help and no team to rely on for support.

When will I see a Doctor? When will I get a bed? These are the questions that are constantly asked when in the Emergency Department (ED). The Canadian Association of Emergency Physicians (CAEP) & National emergency Nurses Affiliation (NENA)(2003) defines overcrowding as a situation where “services exceeds the ability to provide care within a reasonable time, causing doctors and nurses to be unable to provide quality care” (“ED overcrowding”, para. 2). Maintaining access and flow in the ED is essential to the improvement of overcrowding. I am in agreement with the people of Ontario, who state that it is frustrating to wait for hours just to see a doctor or to be transferred to an in-patient unit. Firstly, overcrowding

The implications and effects on patients waiting long hours to be seen in the ED are immense. In a recent study done over five years in Ontario hospitals showed the risk of adverse events and even deaths increased with the length of stay. When ED’s become overcrowded the quality of care changes and declines; which is extremely dangerous. Authors of the study calculated that if ED length of stay was cut by only an hour that 150 fewer Ontarians would die each year. Wait times can also negatively affect patients financially. While untreated medical conditions can lead to reduced productivity and ability to work. As well as delayed access to care can result in more complex interventions needed. Therefore an initiative is needed to provide patients with timely, efficient care when accessing the ED. This would decrease mortality rates as well as patient satisfaction.

The Nationwide Emergency Department Sample (NEDS) is the largest all-payer emergency department (ED) database in the U.S., producing national assessments of hospital-based ED visits beginning in 2004. NEDS gathers information from 31 million ED visits at 950 hospitals. The age is coded 0 to 90 years, and any age greater than 90 is set to 90 [7]. The races include white, black, Hispanic, Asian/Pacific Islander, Native American, and other. The NEDS was designed to enable investigations of ED use patterns and to strengthen public health professionals, administrators, policy makers, and clinicians in their decision-making concerning this critical source of care. The ED serves a dual role in the U.S. health care system infrastructure, as a point

An Analysis of the Los Angeles County Hospital Emergency Room Learning Team Operations Management Plan The problem of emergency department overcrowding has become an important issue for many emergency departments throughout the city and county of Los Angeles. Patients frequently have to wait hours just to get into the emergency department to be seen by a physician or other healthcare professionals. The problem does not seem to be getting better as times goes on, but indeed studies seem to indicate that the condition is growing worse. At a local Los Angeles County Hospital (King Drew Medical Center) emergency department, we found that the problem is especially severe.

Some might think it is beneficial in a business aspect; however, the negative effects have more weight than the positive. As the number of population increases, the ED started to noticed a correlation with increasing crowd which has created in a delay even some patient had to leave without been seen (LWBS) by a physician or PA. The crowding, being able to see a healthcare professional in the appropriate

Jasmin Charles: Essay Why are the waiting times in Public hospital emergency Departments so long? What contributes to this? What are we doing too address this problem?

This study addressed the challenge posed by less-urgent patient population showing up in the ED across Canada. This segment of the ED patients represents a significant proportion of the individuals seeking care in Canadian EDs thereby contributing to overcrowding. The authors hypothesized that less urgent patients might benefit from a targeted approach to care, given that they have conditions that do not require urgent or emergent care but must be seen in an acute care setting like a satellite clinic to adequately address their conditions.