UVA Emergency Room Analysis

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

Besides graduating from college, being accepted into the Counseling program at NOVA Southeastern University was the greatest day of my life. I was on my way to a much greater success by working on my Master. Paying for college out of pocket was a struggle, but I understand that success comes with great sacrifices. However, I wouldn’t really call paying out of pocket for school a sacrifice, but rather an investment in my future and my family. My first semester went marvelous. I was motivated and enthusiastic about the courses. I must admit graduate school is much harder than I imagine, but I manage to make time for studying and ended making A’s in both of my classes, which I didn’t expect less than that. When the summer semester I arrived, I was as excited and motivated as my very first semester, aiming to make nothing less than an A grades. However, unexpectedly my world seemed to have turned upside down in a matter of time. My mother and I decided to take a week to go

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

According to Fort Belvoir Community Hospital Emergency Department head COL Timothy Barron, M.D., the FBCH emergency department sees 52,000 patients per year. This makes it the busiest emergency room in the Defense Health Agency and the 5th busiest in the Department of Defense (T. Barron, personal communication, May 12, 2016). Despite this high flow of patients, the emergency department continues to use paper charting. This increases the risk of error in documenting, ordering and time wasted tracking down the chart delaying patient care. The Fort Belvoir Community Hospital emergency department should move away from the outdated paper charting system to an electronic charting system since many other hospitals as well as departments within FBCH currently use this electronic system; it would save time for patients and providers, and allow for better tracking of care for patients.

Beaufort Memorial Hospital, Beaufort, SC is no exception to this rule. With much of Beaufort County and the surrounding counties being rural and with a high poverty rate Beaufort Memorial experiences a high level of underinsured and indigent care. In 2012 the Medicaid

For my mentor project, I chose to shadow Dr. Kristen James, D.O., a young emergency room Physician (approximately 33-34) who works in the E.R. at Tenova North Knoxville Medical Center. The length of all emergency room shifts are twelve hours—7:00 a.m. to 7:00 p.m., 7:00 p.m. to 7:00 a.m., or 11:00 a.m. to 11:00 p.m.— but for the sake of the well being of my mind and body, I only shadowed for a half of a shift (11:00 a.m. to 5:00 p.m.). I had previously shadowed my father in the same emergency room for a twelve hour shift and I knew that I definitely did not have the stamina to make it through another one with a clear mind or comfortable feet. During this essay, I will be tying in some useful comparisons between shadowing my father vs. shadowing

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

The role of the emergency department is to diagnose and treat acute and urgent illnesses and injuries. Patients are seen in order of medical urgency. The emergency department bases the patients urgency for treatment based on levels. Level 1 is critical and life-threatening. This is usually related to ABC’s (Airway, Breathing, and Circulation). These patients are top priority and require a lifesaving intervention. Level 2 is also considered high priority and can also be life-threatening. Psychiatric patients are considered level 2, and patients arriving to the ED with chest pain. Level 3 patients require resources such as sutures, x-rays, CAT scans, MRI, etc. Level 3 patients are provided treatment services only after Level 1 and 2 have been addressed. The emergency department at CEMC also has a trauma room and a SANE room. The trauma room is equipped with life-saving medications (such as antidotes for drug overdose) and medical equipment. The SANE (Sexual Assault Nurse Examiner) room consists of equipment used to assess a patient who has been sexually assaulted. The equipment takes pictures of the patient for the SANE nurse to later provide to law enforcement. A SANE nurse is a specialty nurse and CEMC has one on call 24/7.

I learned this week that in Humble, Texas, a city 10 miles northeast of Houston, TX that there are free standing emergency rooms that aren’t attached to hospitals, but are targeted for patients that are privately insured. “ASCs are paid about 50 percent of what hospitals are paid for the same procedure. Hospitals argue that this extra payment is in exchange for all the other things that hospitals do (e.g., trauma and specialized care, uncompensated care, etc.) and is necessary for hospital financial survival. Physicians and providers assert that these subsidies are unfairly beneficial to hospitals and subsidize hospitals' ability to employ physicians and move business to hospitals” (Becker, 2012). There are facilities that are called Texas Care Emergency Centers that are, “a facility that feels like a Western lodge with its earth-toned brick walls, leather chairs and coffee bar” (Galewitz, 2013).

Kendra Chappell is a clinical shift manager (CSM) in the emergency department at Forsyth Medical Center (FMC). According to their website, Forsyth Medical Center is a 921-bed, not-for-profit, regional medical center in Winston-Salem, North Carolina, that offers a full range of medical, surgical, rehabilitative and behavioral health services (About us, n.d.). FMC has earned magnet designation from the American Nurses Credentialing Center (About us, n.d.). Kendra has twenty years of nursing experience including working as a Practical Nurse before obtaining her Register Nurse degree 15 years ago. She was a staff nurse in the emergency department for ten years before being promoted to CSM. She has earned a bachelor of science in nursing at Appalachian State University and is a Certified Emergency Nurse. She is certified in basic life support, advanced cardiac life support, pediatric advanced life support, trauma nursing core course, and emergency nursing pediatric course, certifications that are required of all emergency nurses at FMC. Kendra oversees the 81 bed FMC emergency department from 7 a.m. to 7 p.m. every Friday, Saturday, and Sunday. She supervises 25 to 30 nurses and 10 to 15 nursing assistants throughout the course of each shift.

The purpose of the analysis was to highlight potential revenue lost in the Intensive Care Unit by illustrating the lack of charges submitted and lack of a user-friendly system in place to capture the supplies used. Currently there is an unclear process that is carried out across the facility. not just in the ICU division. Each unit has a different way to capture charges, and some couldn’t speak to the process at all. The current ICU analyzed has one Assistant Nurse Manager (ANM) that charges for items by entering items used off a list that is to be filled out by the bedside nurse or charge nurse. Adding the product information into the new EMR under the patient visit charges for the high cost items. If this ANM is not working, the items did

I think many people use the emergency room more like their private doctor instead of a situation of urgency. People tend to visit the emergency room for conditions that should be treated by their physician or at an Urgent Care Center. I think many choose this method because they won’t be turned away based on their ability to pay. Although they still have an obligation for any cost associated with the visit many may not have the means to make a payment then the hospital loses out on those funds. It’s amazing to see how ethnicity plays a role life expectancy. Sierra Leone a country in Africa as an extremely low life expectancy rate due to limited medical facilities in that region. I agree with you that making simple changes such as diet and

Flashing red and blue lights accompanied by an alarming siren in the distance is signaled when the double doors of the emergency room burst open. Pushed by several nurses, doctors, and other medical staff, a lone hospital stretcher with a bloody, wounded patient flies through the medical center towards the doors to the operating room. This image is what generally comes to mind when you think about an emergency room. Many people believe that the hospital’s emergency room is a dark and scary place. While this is true, the common misconception is that the emergency room is a place clear of humor, when in reality humor is present, even necessary, for many reasons. Many television shows, like the show ER, are based in the setting of the

When reading the observations that was conducted to try to forecast their future emergency room needs. The hospital had charted out the data gathered of the number of patients and indicated whether or not the patient count increased on a Friday night, Saturday night, and if there was a full moon that occurred. If the number of patients increased, they added “1" to the chart which shows a growth in the patient count. The hospital needs to use the data gathered to determine how much staff is appropriate for Friday, Saturday and full moon nights. When asked the best forecasting approach for any given day would be demand driven forecasting I would use these seven steps :”determine the use of the forecast, select the items to be forecast, determine