Improving Patient Overcrowding Case Study

A huge effect of boarding patients/overcrowding emergency departments is ambulance diversion. It occurs when a hospital ED cannot accommodate any more emergency patients so

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 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.

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

When people think of health care, they often think up images from their own experiences in doctors' offices, clinics, and hospitals. Then there are the images of intense drama and hustling and bustling in hospitals and emergency rooms such as those presented on television and in the movies. These are all part of the health care arena, but it extends far beyond the emergency room. Health care agencies and governmental agencies mission is to improve the quality, safety, efficiency, and effectiveness of

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

When overcrowding occurs, patients are placed in the hallway waiting for room to be transferred to. Any time overcrowding occurs most ambulances divert away from the closest hospital to the patients and in this situation hospitals lose a lot of revenue. Data published in the US Department of Health and Human Services (HHS) in 2004 report national hospital ambulatory medical care survey on ED summary depicted that ED in United State are approaching a boiling point in terms of increasing patient demand and shrinking bed capacity, Levin et al (Fall,2006). According to the Institute of Healthcare Improvement, a recent survey conducted by the American College of Emergency physician of about 200 hospital administrators, majority pointed at overcrowding as their major constraint and about 60% said overcrowding in their facility forces the diversion of patients with urgent need

St. Vincent’s Medical Center, a 501 bed facility located in Jacksonville, Florida, provides general medical and surgical care to the North Florida Region. St. Vincent’s admits over 26,000 patients annually. The average occupancy rate is approximately 84% with the Emergency Department (ED) peeking at 100% for approximately 4-12 hours daily. The hospital is struggling with availability of bed space. This shortage of available beds creates a bottleneck in the ED on high census days. Bottlenecks are created in the ED when there is a shortage of inpatient beds to place admitted ED patients. Thus, patient flow, or throughput, is becoming more and more important.

The additional revenues that were collected due to increase in ICU capacity by 20 beds enhanced the total ED revenues by 10%.4 The efficiency of care delivery is decreased when patients are diverted to other hospitals, they have to wait for long period to receive care or if they are placed on the floors where they do not belong. This is seen often due to delay in discharging patients.3 These delays and inefficiencies are the primary cause of decreased satisfaction among patients, their families, hospital employees, and physicians. They also result in avoidable increases in patient length-of-stay, reduced quality of care, and lost or diminished hospital revenue.3

The trial court should admit Nellie’s testimony concerning Pete’s medical condition and hospital’s intake form into evidence. The hospital intake form qualifies, under Rule 803, qualifies as a hearsay exception.

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.

Doctors are busy giving family members updates on their loved ones. Traumas are coming in with families in complete fear. Admitting staff trying to get information from the families to get patients registered while trying explain to patients why they must stay, and why some procedures aren’t covered by insurance. The thousands of questions the admitting staff get from patients about their stay all the while being invisible to majority of the staff. That is the Emergency room, that is what an ordinary person walking in does not see. The clicks and the social norms and the hierchy involved in hospital care. The disconnect of clinical staff from non-clinical staff. This same disconnect that contributes to low emergency room patient satisfaction scores, the reason why people leave the ER unhappy. People who work in the ER come in all shapes and sizes. Most of the nurses are females with just a few male nurses, all of which are between 20 to 60 years of age. Admitting staff is made up of males and females from different social backgrounds. The ER is a melting pot, which sometimes can be difficult to

Visit your local Emergency Room on any given day and you are likely to witness a sort of controlled chaos: nurses, doctors, transporters, patient care technicians, and other ancillary staff members all darting about, attempting to meet the needs of increasingly sick patients in oft-overwhelmed and overpopulated hospitals. All around, various alarms sound. IV pumps signal fluid bags about to run dry. Vital sign monitors ping at differing volumes and intensities, in an electronic demand for staff to mind the out-of-normal-range

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).

I definitely agree with you on that in the emergency room (ER), patient-centered care can be a challenge. In the ER it is very busy and not that much is getting communicated with the patients’. If ER care is poorly patient‐centered during normal operations, it is likely even worse during times of crowding. The hospital I work at the ER is so crowded patients’ and their family members have to wait in the halls and lay on the gurneys, and wait for bed availability on the floors. This definitely happened when we had the flu epidemic going on. The ER was so packed and it was very busy and it was hard to communicate with the patients, because the ER nurses were running around from one patient to another. There are some patients that understand that