The Emergency Room Services ( Ed )

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

(Mann, 2014, p.2) These strategies include: broadening access to primary care services; focus on individuals who frequently utilize the emergency department (super-utilizers); and targeting the needs of individuals with behavioral health problems. (Mann, 2014, pp 2-4) Many resources and processes have been implemented in order to help decrease inappropriate emergency department visits. This paper is going to demonstrate some resources and processes that are in place to help individuals obtain health care at the appropriate health care setting.

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

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

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

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

With so many cases of unfilled position in the hospital patients is not obtaining great services. Patient not receiving proper cares leads to closures, because of prolonged postponements that have led to deaths. Patient complaints at the emergency room have increased in recent years. Numerous patients that were admitted to the hospital’s emergency room are at high risk of dying. Six percent of emergency rooms in the U.S. have closed. These closings took place in the inner-city and low-income areas, but with an emergency room visit increasing by nearly 51%, the overwhelming amount of closures.

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

From my experience volunteering in the emergency department at my county’s largest healthcare provider, Union Hospital, I recognize the medical issues,

The Centers for Disease Control and Prevention (CDC, 2017) notes the following statistics pertaining to Emergency Department (ED) visits in the United States during 2013: (a) number of visits-130.4, (b) number of injury-related visits-37.2 million, (c) number of visits per 100 persons-41.9, (d) number of ED visits resulting in hospital admission 12.2 million, (e) number of ED visits resulting in admission to critical care unit-1.5 million, (f) percent of visits with patient seen in fewer than 15 minutes-29.8%, (g) percent of visits resulting in hospital admission-9.3%, and (h) percent of visits resulting in transfer to a different (psychiatric or their) hospital-2.2%.

The emergency room (ER) has been receiving a lot of complaints recently and the chief executive officer, it was decided to find out the root cause of the complaints. This was done in two ways. First is that two individuals were granted the role of observing customers in various locations for about 2 hours per location for a period of one week. They were required to note any issue that arose leading to problems. The second way was that customer feedback forms were introduced in all major rooms of the ER to capture the customer experiences. The observations and feedback was collected, collated, prioritized and discussed. The ER was found to be receiving an average of 9.8 complaints per day which was higher than the average for many other facilities ADDIN EN.CITE Zuckerman20041264(Zuckerman & Shen, 2004)1264126417Zuckerman, StephenShen, Yu-ChuCharacteristics of Occasional and Frequent Emergency Department Users: Do Insurance Coverage and Access to Care Matter?Medical CareMedical Care176-1824222004Lippincott Williams & Wilkins00257079http://www.jstor.org/stable/464071510.2307/4640715( HYPERLINK l "_ENREF_7" o "Zuckerman, 2004 #1264" Zuckerman & Shen, 2004).

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

Middletown Hospital is a 200-bed, not-for-profit-general hospital that has an emergency department with 20 emergency beds. The emergency department handles on an average 100 patients per day. The hospital’s CEO has authorized the Six Sigma Team (SST) to address complaints received from patients seeking treatment between 6:00 p.m. and 10:00 p.m. The complaints are centered on waiting times and poor service. During this time the data indicates that approximately 70% of the department’s admissions occur (University of Phoenix, 2009, Course Syllabus).

The emergency room has become the new primary care facility for the millions of uninsured in the United States. Thanks to an “unfunded mandate passed into law in 1986,” hospitals that participate in the Medicare program must “screen and treat anyone with an emergency medical condition” (Stephens & Ledlow, 2010). This unfortunately leads to emergency rooms full of people who may have something as simple as a sinus infection which then makes it really difficult for someone with a real emergency that did not require ambulatory transport to be seen in a timely manner. Another unfortunate result of this is that “over 1,100 emergency departments closed over the past decade” (Stephens & Ledlow, 2010).