The Medical Priority Dispatch System

If an ambulance is to achieve and work capably, lateness should not be put up with and sometimes if the ambulance was to arrive late at a certain house they could officially put a person’s life at risk.

Without this law many individuals were denied services, and resulted in death or more serious injury to individuals. Hospitals must have a plan in place during an emergency to triage individuals. Medical care to individuals, who lack the monetary resources, have improved because of this law. As the law states, “transfers” of clients cannot be arbitrary and based on financial loss to the hospital.

“To provide the appropriate hand-off and also determine the appropriate unit/bed selection for all hospital medicine patients admitted through the ED (p.688).”

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 filing of the complaint must be completed within 72 hours of the transfer (Sally Austin, 2011). As a result of this, it has been difficult to see whether or not EMTALA has truly been successfully implemented and effective (Sara Rosenbaum, 2012). Another disadvantage is that EMTALA only requires hospitals to treat “true emergencies”, which are subjective in nature. The last revisions in 2003 for EMTALA by policymakers and CMS limited EMTALA to only patients that arrived to the emergency department, not to other areas of the hospital, such as a doctor’s office appointment or outpatient surgery (Sara Rosenbaum, 2012). Another negative consequence of EMTALA that is not addressed by the law is that emergency department physicians can still be held liable and face malpractice issues by uninsured patients (Singer, 2014). There have been legislative proposals by members of Congress that are working to change this to include physicians as members of the Public Health Services, which would address these concerns (Singer, 2014). These hesitations by physicians has forced some hospitals to close their emergency departments in California to avoid these financial consequences of lawsuits (Friedman, 2011).

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 as a part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. EMTALA was enacted to prevent hospitals with Emergency Departments from refusing to treat or transferring patients with emergency medical conditions (EMC) due to an inability to pay for their services. This act also applies to satellite locations whom advertise titles such as “Immediate Care” or “Urgent Care,” and all other facilities where one-third of their patient intake are walk-ins. Several rules and regulations to this act have been established and it has become a very serious piece of legislation and health

To properly reduce these wait times in Canada and to bring it up to par with the international average, Canada will need to start changing things province by province. This will ensure all citizens, especially our older adults, are receiving the best possible care. Some changes could be financial incentives, policies, increase available resources, and implement new technologies to increase patient flow (CIHI, 2012).

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

St. Vincent’s Medical Center, a 501 bed facility located in Jacksonville, Florida, provides general medical and surgical care to the North Florida Region. St. Vincent’s admits over 26,000 patients annually. The average occupancy rate is approximately 84% with the Emergency Department (ED) peeking at 100% for approximately 4-12 hours daily. The hospital is struggling with availability of bed space. This shortage of available beds creates a bottleneck in the ED on high census days. Bottlenecks are created in the ED when there is a shortage of inpatient beds to place admitted ED patients. Thus, patient flow, or throughput, is becoming more and more important.

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.

As of October 1, 2015, all healthcare providers will be required to stop using ICD-9 and start using ICD-10. Switching over to the more in depth system of ICD-10 will require adjustments from large healthcare providers, like hospitals, as well as small practices run by doctors in order to successfully adapt. Some will have to adjust more than others. While hospitals are bigger and more complex, they will have an easier time adjusting to ICD-10 than small practices, which are operated by a single physician or a group of physicians.

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.

“Hospitals are not only required to care for emergency patients, but they also are required to do so in a timely fashion” (Pozgar, 2010, p. 272). “Hospitals are expected to notify specialty on-call physicians when their particular skills are required in the emergency department. An on-call physician who fails to respond to a request to attend a patient can be liable for injuries suffered by the patient because of his or her failure to respond” (Pozgar, 2010, p. 271). Under the doctrine of Respondeat Superior, hospitals are also liable for the actions of physicians working or on-call in their emergency department.

ICD-9-CM is obsolete and cannot meet the requirements of healthcare’s data management. It cannot correctly define the diagnoses and inpatient procedures for care provided. ICD-10-CM will have the increased coding capacity to accommodate advancements in medical technology and procedures that ICD-9-CM cannot accommodate. By October 1, 2015, all entities covered by the Health Insurance Portability and Accountability Act (HIPAA) must transition from ICD-9-CM to ICD-10-CM.

America’s emergency rooms see this type of critical events as a daily occurrence. Often you will find that people will go to the emergency department for care because the ER cannot refuse to care for that come to be seen. If we look into the Emergency Medical Treatment and Active Labor Act any person seeking care must receive assessment and immediate care for their ailment. Often the issue is financial, if a patient is seen at a doctor’s office co-pay or full payment is required at the time of service. With many Americans that do not carry medical insurance their ability to attend to the issue prior to it becoming an emergency is not