Pediatric Orthopedic Clinic Case Study

Hospital emergency room wait times are the talk of the United States right now. Long wait times can contribute to the problems that decrease the quality of our health care system. Emergency room wait times depend on how busy the day is going, how long it takes for each patient to be seen, and how much staff is on duty. Wait times are also based on your injury as well. If you are there for a broken toe versus a head injury, you are going to be seen after the patient with the head injury despite the fact that you were there first. A case study researched and and written by Kevin Tuttle explains a challenge with a mission to decrease the wait times in the emergency room department.

When she sees a patient for the first time she talks to them about the doctor’s report and asks specific questions about their injury or experiences leading up to the need for physical therapy. Megan explained how important it is to make the patient feel comfortable and keep a positive attitude towards the patient’s recovery. These consultations were the most interesting to sit in on because it allowed me to observe the therapist’s ability to take the patient’s information and create a diagnosis and treatment plan for the injury or pain described. Megan may have multiple patients at a time so she stressed the importance of keeping up with each patient and why the physical therapy techs are so helpful. Scheduling is another job of the therapists that is important in keeping the clinic running smoothly. There is also paperwork that has to be filled out for every patient after every visit about their

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

The entire hospital holds a total of 90 beds, 5 operating rooms, 6 examination rooms, and a laboratory. Despite the size of the hospital, they average 150 operations per week and 7000 to 7500 operations annually. Also, it is important to note that there are only 12 full-time surgeons and 7 assistant part-time surgeons that handle all operations in 5 day a week period. The last thing to take into consideration is that each patient stays 3 days out of a week starting the day they arrive. Although Shouldice’s operations seems to be functioning just fine, there is a debate of effectiveness of whether or not they are fully utilizing their full potential in relation to surgeries performed and beds being

Moreover, the office visit length will be shortened due to the high demand of customers making it harder to provide good quality of care to patients as well . On the other hand, from the physician point of view it is predictable that doctors will change practice patterns from private offices to hospital services because the facilities pay salaries with less expectations in the number of patients seen per day. Furthermore, due to the elevated number of patients, time left for clinical documentation and record keeping will be nulle.

It is easy to understand the rushed appointments. Physicians regularly see close to 20 patients per day. Furthermore, the medical model focuses primarily on diagnosing and treating the illness at hand, at the expense of seeing the whole clinical picture. This often leads to frustration and decreased motivation to seek follow-up care.

He had to drive approximately 140 miles to get to his VA hospital. Upon arrival, he described it as “depressing” and “unprofessional.” Upon further discussion, the veteran reported that the building was “extremely run down.” While discussing service, he reported that the hospital and providers were either “way overbooked or understaffed.” He was also discouraged with the service he received from the doctors. He decided to get a second opinion from his family doctor when told that his disability payment would not be increased for a crooked vertebra in his back, which causes him extreme pain. Mason discussed the process of making an appointment: he recalled that he had to wait four to six weeks, to see a provider. That is over two times the expected wait time. He reported that instead of the suggested two week period, he had to wait four to six weeks, causing him to wonder if he was placed on the “phantom waiting list.” Not only was he annoyed with the wait time, but also the actual process of making an appointment. He reported that he had to call three different people to make an appointment, but if one of those people were gone, nothing would get done until they returned because there was only one person that did that particular job (A. Mason, personal communication, September 20,

The Global News article brings to light how bad the wait times in emergency rooms really are with people 55 and older waiting more than 2 days to see a doctor. This article informs the public of the situation providing enough statistics and resources in a reader friendly tone, while giving examples of how a province, like Saskatchewan, is

The surgical unit at Trinity would be complementary to the new orthopedic center in that we have surgical units that are equipped with the latest digital equipment and robotic surgery. As well, we have the facilities within our surgical unit to accommodate the increase in orthopedic cases. It is believed that the surgical facilities are why we are attracting groups of orthopedic practices that want to locate closer to Trinity and are applying for privileges to our hospital. We currently provide 20 operating rooms and have all basic support services necessary to compliment the orthopedic program, such as: basic x-ray, 2 CT scanners and one MRI scanner, nuclear medicine, ultrasound services, and we also have a mobile PET scanner, which is available 2 days per week. Our greatest strength is a competent and dedicated nursing staff which boasts a greater than 75% orthopedic nursing certification rate. We may not

I am the physical therapy team leader at a pediatric outpatient physical and occupational therapy clinic. This clinic evaluates and treats children between the ages of birth and 21 years with a variety of conditions, including, but not limited to: developmental delays, orthopedic and neurological conditions, brachial plexus injuries, torticollis and plagiocephaly, and autism spectrum disorders. Occasionally, the therapists will evaluate and treat an adult patient with developmental disabilities. The clinic is open five days per week with four occupational therapists, three physical therapists, one physical therapist assistant, and a Spanish-speaking interpreter. As the physical therapy team leader, I work with the occupational therapy team leader to suggest, establish, and implement new programs at the clinic, under the direction of the therapy manager.

There are many key components in approaching access to health care: coverage, services, timeliness and workforce (Healthy People 2020, 2015). Patients who have a positive and consistent source of care will ultimately have better end results, minor discrepancies and fewer costs (Healthy People 2020, 2015). Timeliness is the health system’s capability to optimize services in a convenient manner, whether it embraces the time spent either waiting in a doctor’s office or an emergency department. At the same time for many patients it encompasses the time between analyzing the need for tests or treatment and obtaining those results. Working as an ER nurse there has been incredible long waiting times in emergency rooms secondary to the fact that people are using the ER for care and more notably as their primary care physician. Likewise prolonged Emergency department wait times can decrease patient satisfaction and notably people leave without been seen. Finally the different element of workforce is vital in contributing access to health services. Primary Care Physicians (PCPs) play an important role in providing access to health services and it has been noted that many medical students are leaning away from working in primary care (Healthy People 2020, 2015). Our ultimate goal is to direct them towards that needed profession.

PER REPORTER: Kristen said a report was made on Sonny by another registered nurse (Becca) who also works for the Pediatric Clinic on January 5, 2018. Kristen said she tried calling to follow up on the report which was made by Becca by called CPS in Forrest County. However, Kristen said there were no Social Workers there for her to speak with regarding the report. Kristen said Sonny was scheduled to come into the clinic on yesterday January 15, 2018 to have his weight checked. Kristen said Sonny has poor weight gain due to his mother not waking up in the middle of the night to feed him. Kristen said the child’s mother was a no show for the child’s appointment on yesterday. Kristen also said there is history documented in the family’s hospital

In 1998, the Massachusetts General Orthopedic Associates (MGOA), a specialized unit within Massachusetts General Hospital (MGH), hired Dr. Harry Rubash and Dr. James Herndon, respectively, to help to remedy the annual financial deficits, which were “financed” by dipping into endowment and borrowings from MGH. These financial deficits have been continually getting into MGOA’s mission of providing high-quality patient care, research, and teaching (Barro 3). In the immediate months after accepting their positions of leadership, both Rubash and Herndon steered the hospital into the green turning a modest profit. However, it was clear that their new initiatives wouldn’t be viable for the long term. To do so, Rubash and Herndon proposed a new physician compensation plan. This plan included a development fund tax, a bonus, in addition to periodic adjustments to a base salary based on individual physician performance in regards to how profitable the physician was for MGOA. Initial physicians’ reaction to the proposed plan varied, however, if the case study was an indication, Rubash and Herndon were determined to implement their plan.

In order to alleviate the long wait times, the clinic either needs to hire more physicians at an additional cost of $55,000 each, or the clinic needs to find ways to increase the utilization of the nurse practitioners to reduce the burden carried by the physicians. In light of the comparatively high cost of hiring physicians as compared with the cost of increasing the utilization of the nurse practitioners, we recommend taking the following steps instead of simply hiring additional physicians.

Description: Orthopedic surgeons are experts in treating the conditions of the musculoskeletal system. Read about Indian orthopedic surgeons on Tour2India4Health.