Medical Director For Ems Hospitals For Observation That Provide Different Shift Patterns

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

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

Urgent Ambulance Services is a company that is to service its community by providing urgent and non-emergency medical pre hospital care. The organization would be serving their communities by promoting health, and safety educations in the communities they service. The organization is to educated young and old of First Aid, CPR, and safety to install the awareness and promote healthy choices. The organization is to also provide effective and prompt pre-hospital Medical services to community that calls for any non-emergent and emergency medical help, and transportations.

In this article, the authors investigated the vulnerabilities in emergency department to internal medicine patient transfers through self-administered surveys of all emergency medicine house staff. More specifically, the survey investigated adverse events due to faulty communications during handoffs. According to this survey, 29% of the emergency staff reported either an adverse or near-miss event due to errors during handoffs. Furthermore, the survey respondents identified inaccurate or incomplete information, cultural and professional conflict, crowding, and many other factors as the contributors to handoff errors. By identifying specific contributors to handoff errors, this article serves as guidance for handoff intervention.

As the chief compliance officer, I would first have a meeting with the Emergency Room Director/Lead ER Nurse to discuss this problem. This department has the first interaction with these patients and later works with the physicians to give care. I will go over the cases and set up a meeting with the staff to go over what constitutes a patient to be classified as inpatient. I would then proceed to meeting with the Chief of Medical Staff to discuss the cases so the chief can talk to those physicians and see what their judgement was on this case. I would then go to the Billing department to go over to notify them of this mistake, where they can discuss it with the CFO.

NARAP studies on the emergency department as a platform to facilitate primary health care screenings follow this model. During their weekly shifts, RAs approach as many non-emergent patients and their visitors as possible to ask a detailed history on the prevention or screening issue under study. Working within Research Associate program at HUMC, I will be able to gain access to the epic database which provides the university center with electronic health information. I

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

First off, there are several settings in which an EM PA can provide care. These settings include emergency departments, urgent care and critical care units, pre-hospital situations such as ground or air transport, as well as, education and teaching activities in regards to EM. Besides the opportunity to choose a certain setting to practice in, you also have the opportunity to care for a large variety of patients ranging from newborn to elderly. Unlike other PA specialties in which patients present with similar diseases and injuries, EM opens the door for one to see and care for a large variety of illnesses and injuries. Patients can present with anything from the flu to broken bones to life-threatening problems like heart attacks or severe trauma from automobile

As part of this evaluation we are interviewing with all participating EMS agencies at their own locations rather than sending a survey for you to fill out. The reason is we would like to see firsthand the challenges you face in the field.

The Emergency Medical Service(EMS) are the people who will usually respond to a 911 call relating to medical emergency.

Thus, emergency physicians cannot rely on earned trust or on prior knowledge of the patient's condition, values, or wishes regarding medical treatment. The patient's willingness to seek emergency care and to trust the physician is based on institutional and professional assurances rather than on an established personal relationship. Fourth, emergency physicians practice in an institutional setting, the hospital emergency department, and in close working relationships with other physicians, nurses, emergency medical technicians, and other health care professionals. Thus, emergency physicians must understand and respect institutional regulations and inter-professional norms of conduct. Fifth, in the United States, emergency physicians have been given a unique social role and responsibility to act as health care providers of last resort for many patients who have no other feasible access to care. Sixth, emergency physicians have a societal duty to render emergency aid outside their normal health care setting when such intervention may save life or limb. Finally, by virtue of their broad expertise and training, emergency physicians are expected to be a resource for the community in pre-hospital care, disaster management, toxicology, cardiopulmonary resuscitation, public health, injury control, and related areas. All of these special circumstances shape the

Tang N, Stein J, Hsia RY et al: Trends and characteristics and US emergency department visits, 1997 – 2007.  JAMA 2010; 304: 664-670

In virtually every community in this nation, the emergency department (ED) is an integral part of the health care safety net, often serving as the only available point of access to the health care system for many vulnerable and disenfranchised individuals. The authors present a brief overview of the March 2000 report released by the Institute of Medicine that described and assessed the current status of the nation's health care safety net. The authors discuss the role of the ED as a safety net provider and as a window onto the status of the rest of the health care system. The authors describe the Andersen behavioral model of health services use and suggest it as a useful theoretical framework for emergency medicine researchers who are interested

According to Community Paramedic Taskforce Results 7/1/15-12/31/15 (2016), the average patient age was 71 years old, and 61% of these patients were female (n=247). This data is consistent with Rittner and Kirk’s study (1995) relating to age and gender distribution. In 2015 there were more people in this age group than in 1995, which increases reliance on EMS for services that do not always fall into the emergent category, yet do need intervention of some sort. To reduce burdening the EMS system with addressing non-emergent needs MIH/CP programs seek to connect the right patient, with the right care, at the right time. However, some of these patients are limited in mobility and cannot travel to a primary care provider to receive care.

There might be many factors that contribute to noise such as the nursing activities and conversation especially during shift change, increase in visitors and patients, technology such as computer, cell phones, and television, old equipment, non-clinical events, and external environment. I believe these root causes can be prioritized depending on the impacts they have on patients. Since the medical center is a teaching hospital, I suspect that numbers of residents, researchers, and visitors during the night can be root cause of the problem. In addition, beeping monitors, television volume, open doors, noisy linen cart, and conversation between staff during shift change can be the contributing factors.