Emergency Department Patients: Article Analysis

Hospital emergency room wait times are the talk of the United States right now. Long wait times can contribute to the problems that decrease the quality of our health care system. Emergency room wait times depend on how busy the day is going, how long it takes for each patient to be seen, and how much staff is on duty. Wait times are also based on your injury as well. If you are there for a broken toe versus a head injury, you are going to be seen after the patient with the head injury despite the fact that you were there first. A case study researched and and written by Kevin Tuttle explains a challenge with a mission to decrease the wait times in the emergency room department.

The main key issues in case #5 is that the MMG system had not achieved its overall financial performance goals; therefore they experienced a big loss secondly the transition of new leadership became an issue. The difficulties of implementing the MBS business model in the Hospitals and Clinics division also became a very important issue. Having to come up with a strategy to improve the financial side and being able to focus on customers and relationships was not an easy task for them. Hospitals had a different approach of helping customers in

When focusing on the Centers for Medicare and Medicaid Systems strategies for improvement with unnecessary emergency room visits, a major key area is accessibility to health care at the appropriate health care setting. For many years, there has been the perception that the emergency department is the only place for someone who is uninsured or underinsured can go to receive the needed and appropriate health care, and in some situations that may be the case. (Rhodes et al, 2013, p.394) Due to the decreases in reimbursements for the publicly funded, more and more physicians are opting out to treating these patients, thus leading to an increase in emergency department utilization. According to a study conducted by Rhodes, Bisgaier, Lawson, Soglen, Krug, and Haitsma, this is becoming a greater concern for the

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

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

Emergency Department crowding is a cause for great concern. It is costly and responsible for compromising quality of care and community trust (McHugh, VanDyke, McClelland, & Moss, 2011). According to McHugh et al. (2011), improving patient flow can mitigate ED crowding. This paper will describe a plan to implement an ED fast-track area (FTA) as one solution to improve patient flow and reduce ED crowding. The author will describe the approval process, review the problem, discuss the proposal, explain the rationale behind the proposal, examine the evidence, describe the implementation logistics, and determine the necessary resources required for implementation.

Improving hospital management can reduce emergency room waiting times. “ER Director Jim Schweigert says it’s all about managing the entire hospital flow. (Costello, 2006) This statement is true because in order to improve ER waiting times the management of the entire hospital flow should be looked at closely. “Think of the emergency room like a restaurant where people come in and go out. Now imagine a restaurant where the customers come in, but never leave. They come in for breakfast, they stay for lunch and they’re there for dinner.” (Rice, 2011) When looking at the ER like a restaurant it gives you insight as to why wait times are so long. The overall process of the hospitals internal control should be examined for flaws in specific departments that are causing delays in the processing of patients.

The presence of Emergency Department (ED) crowding, and long boarding times, hinders its ability to provide the quality and efficient care (Weiss, Rogers, Maas, Ernst, & Nick, 2014). According to Mullins and Pines (2014), an average patient in the United States spends more than 4 hours in the ED before being admitted to an inpatient unit. ED crowding and increased boarding time have negatively impacted bed availability, increased staff workload, decreased productivity, and lessened patient satisfaction. Many healthcare organizations, including the Veterans Health Administration (VHA), have established an electronic bed board system (BMS) and InterQual Level of Care Criteria (IQLCC), which aim to enhance patient flow within organizations (United States, 2013).

There are are multiple consequences of visiting the emergency department for non-urgent needs. Moskop (2010) identified overcrowding, expensive care, and suggested lower quality of care. The consequences seemed to be universally consistent with varying descriptions. For example, Boyle (2015) identifying long wait times as a consequence but this is an effect of

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

Misdiagnosing is something that happens often and can result in medical malpractice. When seeking medical advice you put your trust into the health care provider to take the appropriate measures to determine the correct diagnosis. However, there are times that providers can make mistakes which leads to an improper or delayed diagnosis. Failing to properly diagnose a patient can prevent patients from receiving the correct treatment. By receiving improper treatment patients are at a risk of further injuries and possible fatalities. “The most common missed diagnoses for adults were cancer and heart attacks. Other that were commonly-occurring were appendicitis, ectopic pregnancy, and bone fractures. For children, the most missed diagnoses were

This week's reading in regards to patients care was very educational in learning the struggles of millions of Americans in need of healthcare. The shift from fee-for-service to manage care such as HMO has made it difficult for patients to get the proper health care. Strategies used by HMO included restricting patients choices of physicians; controlling their access to care, limiting the treatments their physicians prescribed; limiting the doctors ability to refer them to specialists and evenually damaging the patient's trust in their doctors.

Some factors that contribute to the decrease in quality and time efficiency of patient care due to misdiagnosis and delays in treatment are as follows:

Planning. An indicator of quality emergency medical services care is measured by how frequently the PAU achieves a 4-minute response time (Pons, Haukoos, Bludworth, Cribley & Markovich, 2008). Although an 8-minute response time is followed by many communities, this guideline has not been shown to substantively improve patient outcomes; however, a survival benefit has been identified when the response time was within 4 minutes for patients with intermediate or high risk of mortality (Pons et al., 2008).

With this goal, Thomas Jefferson University Hospital created a fast track team consisting of a nurse practitioner, nurse, and a tech for signage at the entrance to reduce throughput time (McHugh, Van Dyke, McClelland & Moss, October 2012). However, this takes way staffing in the Emergency Department treatment area that can help to reduce additional excessive throughput time.