Patient Overcrowding

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

Cooper is an inner city hospital where most of its residents and patients fall into the low income population. Individuals are unable to pay for or can’t afford health care. Therefore, they do not have primary physicians to refer to. This causes people to utilize the emergency department as their doctors office. Ultimately, this arises a concern for overcrowding of Cooper’s emergency department. Overcrowding of emergency departments across the United States has the potential to become a debilitating situation. Overcrowding arose as a phenomenon in the 80s and has now reemerged as a nation wide issue. As you walk through

In the Emergency Department, does implementing the emergency severity index algorithm along with an online training component improve the accuracy of triage acuity rating assignment by registered nurses ultimately decreasing left without treatment (LWOT), length of stay, and staff satisfaction.

“Long wait times could potentially result in worse patient outcomes, greater patient suffering, patient dissatisfaction, more difficulty retaining and recruiting staff, a higher risk of infectious disease outbreaks and an increased risk of medical errors” (Ducharme, Alder, Pelletier, Murray, & Tepper, p. 456). This article explored how the addition of nurse practitioners and physician assistants in 6 Ontario emergency departments could help to reduce wait time, patient flow, and the number of patients who left without being seen (Ducharme, Alder, Pelletier, Murray, & Tepper, p. 455). This study was seen to be the first of its kind in analyzing effects in an emergency department on patient flow by adding nurse practitioners and physician assistants to the healthcare team (Ducharme, Alder, Pelletier, Murray, & Tepper, p. 459). The quantitative study design used for this study was the experimental design since it was based on implementation and evaluation of the effects (Keele, p. 41). The article does not address how the sample size was determined and actually

Well collaboration between physicians and decreasing boarding time in the E.D also provide good patient experience in EmCare.

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).

Soleimanpour et. al (2011) explained that patient satisfaction is an essential component in the Emergency Department (ED) because it is the entrance for patients to receive their initial treatments. The most important and single possible cause for ED patients’ flow problem is the availability of inpatients beds (Peck et. al, 2012). The American College of Emergency Physicians (ACEP) (2011) explained that the primary cause of ED overcrowding is boarding; which was defined as holding patients in the ED after the admission had been completed due to unavailability of inpatient beds. Lutheran Medical Center faced this problem and in his paper will discuss analysis of the problem, determination of possible quality lapses, identification of performance measures, designing and evaluation of the interventions and reporting of the results.

While most of triage and routing occurs in the PCPs office or through an after-hours call system in a timely manner, the medical triaging system does not always work efficiently. Persons whom are uninsured, or insured yet lacking a PCP, resort to using the emergency room for nonurgent care (Baker & Baker, 1994). Without a PCP to act as a router, and without access to a 24-hour phone support, these individuals' options are limited. If their medical problem occurs at night, or if they are unable to make it to a walk-in clinic during the clinic’s hours because of work, childcare, or other responsibilities, the emergency room becomes the only option. This puts a huge strain on the emergency care system, since a large portion of its resources

The research question for this study is, can the addition of a nurse practitioner into an emergency department have an impact on patient wait times, length of stay, and patients who leave without being seen? The hypothesis of this study is that there will be a reduction in wait time, length of stay, and patients who leave without being seen by adding a nurse practitioner as a provider to the emergency department. The dependent variable in this study is the addition of a nurse practitioner, while the independent variables are the patient wait times, length of stay, and patients who leave without being seen. A conceptual framework was used in this study, since the authors were specific about their idea of study. The related literature shows that there is an overcrowding issue in emergency departments and show that wait times and length of stay can be impacted by nurse practitioners. This study was performed by using a quantitative, experimental study design, in which a nurse practitioner was introduced into an emergency department, then the results were obtained by comparing before and after data. For this study data was collected from 3238 emergency department

This report includes the recommendation for solving this problem, the supporting reasons for the recommendation, the counterargument and rebuttal, and a concluding section. In addition, this report examines the negative impacts of primary care utilization of the Emergency Department, the advantages of connecting patients with a primary care

The Emergency Department (ED) overflows daily with people seeking immediate medical attention. There are some who may present with life-threatening illnesses while others utilize the ED as a source of primary health care. The ED has become the only guaranteed access to health care for 44 million uninsured Americans and has led to the overcrowding of emergency departments (Trzeciak & Rivers, 2003). To prioritize incoming patients and to identify those who cannot wait to be seen the use of the Emergency Severity Index (ESI) in the emergency department was conceptualized. The emergency severity index is an acuity based model that assigns a level by the triage nurse to patients presenting to the ED for treatment. ESI is a tool used by emergency

In this method we assigned a waiting area just next to the registration area, for those patients with less severe health problems (level 4 or 5), with a physician room including a bed and all the necessary equipment they need for treatments. There is also a nurse helping the physician to increase productivity through improved communication and teamwork. In this method when the triage nurse prioritize the patient as a less injured and ill, they send the patient to the RTS area right after the triage where they are receiving tests and treatments in minutes, not hours.

The literature review concentrates on the LWBS data and identifies reasons that LWBS rates may decrease. In this study, the author points out that many patients who receive a certain level of care during triage, such as pain treatment, x-rays, etc., may wait longer than those who do not receive those interventions. As discussed by the researcher, the potential for patients to leave without receiving proper care can increase based on age, race, triage acuity, arrival method, gender and payment. It is important to note that length of wait in the emergency department would also effect these outcomes.

Triage is vital in vital in large-scale medical facilities, like the public hospital where the participant was treated. Not only is triage effective from a physical care perspective, but also the immediate care from health professionals can provide a sense of security to the patient.

We used the ER department statistics evidence related to the ER delay, patients feedback, and literature. Based on our team discussion, the complementary information and ideas received from patients and other experts who understand care coordination, we focused on gathering relevant information that helped our decision in care coordination, speed improvement and measurement and quality management of the ER triage area. Spath,(2014) states that To test whether these changes have improved outcomes, the [ ER] continues to gather feedback on overall patient satisfaction and periodically collects and analyzes patient wait time data. We use measurement; statistics used to report