Inadequate Staffing And Emergency Department Capacity

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 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.

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

Approximately half of a million Americans are homeless, living in shelters or on the streets at any one time (Galea & Vlahov, 2002). The homeless population utilizes the emergency room to gain access to, primary care, nutritional, pharmaceutical and basic needs with non-medical issues is a contributing factor to emergency room overcrowding. The non-medical can primary care component needs to be moved out of the acute care setting of the emergency room but still readily accessible to the homeless clients.

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’.

Once you arrive at the emergency room, you experience more waiting depending on your current condition. Some of these waits depend on: length of stay, time waiting for assessment, condition, waiting for inpatient bed, and lack of resources. Finally, when you’re ready to leave the emergency department waits can occur, like waiting for an inpatient bed or a ride home (CIHI, 2012). All of these reasons impact the growing wait times, with older adults becoming more frequent in emergency departments and the increasing population of older adults these wait times are going to continue to grow causing more harm than good, if older adults are unable to receive the appropriate care in a timely matter (Cooke, Oliver, & Burns, 2012).

Emergency departments are considered an important aspect of the health care system. For many years, wait times have been an area of concern for many Canadians and remain a significant issue. One of the major concerns within the Canadian health care system is the amount of time spent as waiting time in the healthcare services. Wait times are the length of time from when the patient is triaged and registered, to when the patient leaves from the emergency room (Affleck, Parks, Drummond, Rowe, & Ovens, 2013). Whether waiting for a doctor, waiting for prescription medication, or even waiting to get tested, the reasons for wait time in Canada are caused by many factors (Cole, Hopman, & Kawakami, 2011). This paper will seek to examine the factors contributing to longer wait times in the emergency department, examine the ways in which wait times impact society, and conclude by presenting possible solutions to reduce wait times.

Francis, M., Rich, T., Williamson, T., & Peterson, D. (2010). Effect of an emergency department

Assess the current Models of Care in their Emergency Departments using the given criteria It is recognised that not all of the Models of Emergency Care are applicable for all NSW Emergency Departments. Decisions to implement them will be made based on the staff, patient presentations and space available in the ED to operate each model. Assess the potential to introduce models to their hospitals that may improve patient care and flow, the patient experience and clinical outcomes

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

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

There are Emergency rooms all over the United States that are being utilized as primary care provider., by patients covered by private insurance, Medicaid, Medicare as well as the uninsured.(Baker, August 13, 2008) Some patients call their primary care provider and are told, they cannot be worked in for several days or weeks. The option given is to go to the Emergency room for treatment. Other reasons are people who do not have a primary care provider or insurance. Primary care providers do not want to take new patients without insurance, so their only choice is to go the emergency room for treatment. Another factor driving Emergency Room volume trends are physicians who send

The American College of Emergency Physicians (ACEP) states crowding as, “the identified need for emergency services exceeds available resources for patient care in the ED, hospital or both” (acep.org). What is fueling these incidents is the rapid increase in ED visits combined with diminishing numbers of ED. In a study conducted by the Academic Emergency Medicine explains that, “ ED crowding is worsening in the US as demonstrated by longer waiting times to see clinicians and is likely exacerbated by the worsening problem of ED boarding, where admitted patients often stay for long periods in the ED waiting for inpatient bed placement” (Aronsky et al., 2011; p. 528). Crowding could possibly affect clinical outcomes, such as mortality, which may adversely lead to delays for time sensitive patients. These outcomes would then lead to a higher rate of patient dissatisfaction within the ED, thus leading to an increase amount of patients left without being seen (LWBS) rates.