Evaluation Of The Emergency Department

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

They can commit to excellence by creating a great working environment for physicians; through efforts such as having plenty of medical supplies in the hospital and offering reasonable pay. When there are available equipment physicians, and other hospital staff remain motivated to carry out their duties and, therefore, will put effort to excel in all their duties; to promise patient satisfaction. Again, medical facilities can create excellence by having a suitable environment for continued learning; seeing as the medical world is full of new discoveries and research findings. Continued learning ensures that the practices that physicians undertake remain important; thereby ensuring that patients feel that they receive high quality services when they visit a hospital (Marley, 2004,

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

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

There are many components to a hospital or medical facility. All of them are necessary to have a properly functioning environment. The emergency department of a hospital is a fast paced world. You have to be constantly on your toes and prepared for whatever may come through the doors. There are many people that work in an emergency room to make it run smoothly. Techs, nurses, CNA’s, LVN’s, and doctors all work side by side to help those who are critically injured. Without all these people it would be complete chaos.

    The modern day emergency room is a department that is constantly busy. In the hustle of caring for patients, there are some details of the patient’s care that can be overlooked in a standard phone report to the accepting nurse. With this in mind, a change is needed so that there is an optimum patient outcome for each and every one of the people that walk through the doors of the emergency room and get admitted.

In this paper I will be playing the part as a chief operating officer (COO) and I am responsible for a 15-bed Emergency Room (ER). In this scenario I am facing many complaints within the last year regarding inadequate care, poor Emergency Room management, long wait times, and patients being sent away because of lack of space, staff, or physicians to provide appropriate care. I am asked to (1) Thoroughly diagnose the root causes of the complaints about the clinic, (2) thoroughly devise a strategic plan for overcoming the problems associated with the current Emergency Room, (3) thoroughly justify how the “Good

Any patient brought into the Emergency Department, is first signed in at ED receptionist desk and triaged by a triage nurse, prioritized and brought to patient room by a charged nurse either by wheelchair or stretcher or walking by the patient depending on patient’s illness. A nurse is assigned to the patient. Emergency Doctor comes in and if the patient illness is life threatening it is stabilized and the Doctor orders test such as blood work and x-ray if necessary to be conducted. Based on the test result the patient is either discharged or admitted. Certain times the emergency department is filled with a lot of patient that there is no place to sit and patients keep coming in and creating

One of the major steps to take is to explore the patterns of the staffs and how the interact and relate when it comes to patient care, this will help in establishing a plan that will help the hospital provide the best care, decrease in falls, pressure ulcers and pneumonia

Patients arriving in the ED are triaged by a nurse then placed in an ED room according to their acuity. After being evaluated by a physician, the patient is either released to home or admitted. When the decision is made for the patient to be admitted, a request for an inpatient bed is placed to nursing administration who then assigns an available bed. If there is not an appropriate bed available, the patient must remain in the ED bed. This effectively reduces the capacity of the ED causing the department to either divert patients or patients will leave without being seen. Every patient who is diverted or leaves without being seen is lost opportunity cost to the hospital.

The emergency department (ED) is one of the busiest place in most hospital and time is very crucial in some case. A survey done in 2002, shows that 90% of Level 1 trauma centers and hospital are considered over capacity with more than 300 beds and 62 % of ED considered themselves the same (Milsten, A., Klein, J., Liu, Q., Vibhakar, N., Linder, L., 2014. p.13). Assessment was done to find out the strength and weakness of the current process in use in the ED.

As medical reimbursement begins to focus on patient satisfaction, hospitals around the country are focused on achieving full funding for their Medicare and Medicaid patients (Dyos et al., 2015). In fact, “emergency care remains consumer-driven, and the ultimate success of a hospital ED is defined by positive patient satisfaction and optimum patient outcomes,” (Love, Murphy, Lietz, & Jordan, 2012, para. 1). One of the most common dissatisfactory complaints for emergency department (ED) clients remains length of stay (LOS). Patient flow, or throughput is frequently described when discussing LOS. The flow of a typical emergency room begins with the triage process

The emergency room is a difficult and trying place, as individuals can experience a plethora of emotions before, during, and after their treatment. This film illustrated several common themes within this setting, provided educational information about public health care, and demonstrated several skills I plan to use in practicum and post- graduation.

This current problem correlates with other issues within the emergency department. A study was performed by the Institute of Medicine (IOM) demonstrating the six components of the evaluations of the quality of one’s care; Safety, effectiveness, patient centered care, efficiency, time, and equitability (Strang, Crotts, Johnson, Hartling, Guttman, 2015). The scope of my project involves training, education and changing the way our department interacts with arriving patients and the triaging process. The lack of specific tasks and communication in the triage area also lives. A dearth in communication has been directly linked to delays in patient care, medication errors, and lack of accountability (Sayah, Rogers, Devarajan, Kingsley-Rocker, Lobon, 2014). With the use of appropriate quick triage, communication, and transfer of patients one can implement targeted goals in triage (Craig et at., 2016).

Safe, effective, patient-centered care delivered in a timely and efficient manner is the goal of quality healthcare. Unfortunately, the delivery of such quality faces serious concerns. The Institute of Medicine (2001) describes the quality gap in healthcare as having three types of problems, “overuse, underuse, and misuse” (p. 23). In recent years, emphasis on improving the quality of care has increased (IOM, 2001). Quality improvement methods, such as plan-do-study-act (PDSA), have successfully enabled health care providers to address the quality gap. The purpose of this paper is to identify a quality healthcare problem, discuss the quality improvement plan, and describe the strategy for implementing effective change using the PDSA method.