Health Care Executive Summary

The study revealed several issues in this department. Voluntary emergency patients have to wait extended periods of time before being transferred to the appropriate department. The majority of those who have to wait are those seeking mental health assistance. Keeping people in the emergency department longer than necessary cause operational costs skyrocket, and worse, keeps the needs of patients from properly being met.

Determining which attributes are most frequently associated with ED throughput will allow insight into the concept. The antecedents will be described in the following paragraphs. Clear focused vision; The ED should be viewed as a key customer of the ancillary departments. If the mission is to provide quality compassionate healthcare, then all staff need to work hard towards

There are many major challenges facing the nursing shortage environment today. One of those challenges includes the facility recruitment of registered nurses and then the facility retention of the registered nurses that they have recruited. Factors to consider would be as to why a registered nurse chose to accept a particular job and will they choose to stay at the facility after being given an employment opportunity. A facility’s reputation, union status, autonomy and salary are among some of the factors that influence recruitment. Factors that influence retention includes the inclusion in decision making, practice

The administrator and the director of the nurses had poor communication with staff. They did not show up in the wings and their communication with staff relied just on the staff meetings and it wasn’t appeared in the case that how often they had meeting. They did not discuss the possibility of implementing the job rotation with the charge nurses, before announcing it in the meeting in order to evaluate available resources and decide whether job rotation would be beneficial to the Clinic or not. The principles of such job rotation must be stated in the staff plan, the personnel policy program or the personnel strategy of the workplace. Another issue was the evaluation of the charge nurses. It is not clear from the case that who was doing their evaluation and who was controlling their work? It seems from the case there was no supervisor to control their work and the manager gave all the authority to the charge nurses. So, how the charge nurses knew that they were doing well or know about their strengths and weaknesses. By giving all the authority to charge nurse without any constant control, they missed some vital information. Additionally, because nobody evaluated charge nurse activities they didn’t receive any feedback about their performance. The charge nurses also had a weak communication with their staff. Jennifer, the charge nurse of wing A didn’t have enough time to

The article, I chose is “The Retrospective Analysis of Quality Improvement Throughput Measures at a High-Volume Community Emergency Department”. The article is about overcrowding in the emergency departments; which has caused patients to leave without being seen (LWBS) by a physician or PA and the measurements taken to solve the problem. Two major and other minor changes were implemented to improve the situation. In this paper, I will be addressing the problem of crowding, the strategic plan taken and how the implementations were evaluated in the effort to improve quality care and the outcomes.

Neither staff member identified the downward trending of the patients available vital signs and did not evaluate consciousness of the patient. Failure to assess appropriately and recognize deterioration of the patient resulted in a prolonged period of time in which the patient was not adequately oxygenated. Research has shown that short staffing, with decreased nurse to patient ratio, has been found to be associated with increased mortality (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Joint Commission on Accreditation of Healthcare Organizations, 2005; Needleman, Buerhaus, PKankratz, Leibson, Stevens, & Harris, 2011). This reinforces the need to match staffing with patient census, acuity, and need for nursing care.

. As a director of the ED, I need to resolve the problem as soon as possible. Mrs. Morrigan complained about long waiting hours. My first step will be to find the direct causes for the long waiting times; it may be due to the carelessness of the healthcare providers towards their duty, or it may be due to their failure to manage the time. The next step I will take is to find out the root causes behind these direct causes. The root causes might be understaffing and high workload, the patient to staff ratio may not be optimum, due to which physicians and nurses are not able to manage their time. The other root cause may be a dissatisfaction of the staff towards their job, which may be due to low salary, poor working condition and poor relations

The three governing entities for hospitals-- the medical staff, the administration and the board of trustees—seemingly have the same goals of providing safe, quality patient care and to do so at a reasonable cost. Tension between the three often exists, however, despite the common goals. I believe there are three main reasons for this tension: Mistrust, unclear expectations and lack of communication. These three concepts are intertwined, with each one affecting the other two, so it generates a cycle that is difficult to break.

In the United States, between 1996 and 2003 emergency room visits rose from 9.3 million visits to 113.9 million visits; an increase of 26 percent with an annual visit rate of 35.7 visits per 100 persons in 1992 and 39.6 per 100 persons in 2005 (Hunt, K., Colby, D., Grimes, B., Bacchette, P., Callaham, M., 2008). As the demand for ED services increase, wait times increase, over-crowding occurs, resources are strained and poorer patient outcomes are often the result.

ED overcrowding has been described as putting the critical and the non critical patients at risk of safety. When an ambulance is being diverted to a different hospital

This article addresses the nationwide problem of crowding in the emergency department. Crowding in the emergency department creates delays in care and has been proven to be most prevalent in urban and teaching hospitals across the country. The authors infer that since the institution of the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986, record numbers of individuals seeking care through the emergency department has skyrocketed. Patients either use the emergency department as the first line of care or the last line of care. According to the study, uninsured members of society are most likely to utilize the emergency department for care versus their “sicker” insured counterparts. A survey conducted in 2010 by the American

Executive Summary: Many visits to the Emergency Department are made for non-emergent needs. This causes congestion in the healthcare system and makes it harder for those who truly need emergent medical attention receive the care they need. Aging populations, under or non-insured patients, Medicaid expansions, and Psychiatric/Behavioral Health problems directly impact overcrowding in the Emergency Department. Providing alternative facilities and services, and utilizing Community Paramedicine programs will alleviate the strain overcrowding Emergency Departments face on a regular basis.

A continuous concern that continues to present itself within the healthcare environment is adequate staffing on nursing units. Most hospital organizations try their very best to accommodate staffing needs, though many units remain understaffed for an unspecified amount of time. Inadequate staffing can negatively affect patient outcomes, lead to nurse burnout, and decrease patient satisfaction scores. Combating this issue will require a great deal of effort, as many geographical face nursing shortages when seeking new graduates and qualified candidates. Employees may begin to feel that they are unable to pursue personal goals within a healthcare organization, due to inability to transfer as a result of staffing shortages. This often results in nursing seeking employment or career advancement outside of the organization or geographical area, which further intensifies ramification associated with inadequate staffing.

Taking a newcomer view to the emergency department, one thought stands out: the services given in the ED are often not the intended use of the facility. I found numerous articles which examine overcrowding, patient expectations at triage (mostly wait times), and the high cost of care, with the common conclusion that many of the patients seen in the emergency room should not be there at all. Medicaid defines "Emergency Medical Condition" as a medical condition (including emergency labor and delivery) that manifests itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: placing the patient's health in serious jeopardy; serious impairment

The time sensitive nature of the emergency department makes staffing shortfalls potentially more dangerous than other health care environments. Patients that visited the emergency department of one New York hospital on Saturday, the day the hospital is short staffed, experienced greater levels of infections and death than those that visited during the week (Stock, et al, 2014).