The emergency department (ED) is a critical area within the healthcare environment that acts as the bridge between outpatient and inpatient care. The purpose of ED is to provide acute care services. The importance of the department is underscored by the fact that in the US, Weinick et al. (2014) state that 28% of all acute care visits are handled by the ED. Additionally, nearly half of all the hospital admissions in the US have their point of entry at the emergency department. A large number of patients in the ED makes the environment susceptible to congestion and hence poor quality of health care services. According to Scaletta (2014), the Emergency Department Consumer Assessment of Healthcare Providers and Systems (ED-CAHPS) is one of the national quality strategies set out in the Affordable Care Act to measure the quality of services provided in the ED and hence, the amounts of Medicare to be reimbursed (Kilaru et al., 2016). Before the ED-CAHPS is launched in the ED, it is critical that improvement efforts such as emphasizing efficiency, redefining the admissions process, and dedicating staffing to the admissions process are improved. This paper provides a review of the literature on the best possible ways in which the patient ED can be enhanced to ensure that the ED-CAHPS launch is successful.
The efficiency of the ED is measured by the waiting time of the patients as well as the quality of services offered. Research shows that the satisfaction of patients has an inverse relationship with the waiting time in the ED. Notably, according to Scaletta (2014), waiting for more than six hours led to a more than 10% drop in the satisfaction of patients. In this regard, before the launch of EDCAHPS survey, it is critical that a healthcare organization makes efforts that will see a reduction in the number of waiting hours as this will translate to increased efficiency. Notably, Kilaru et al. (2016) are of the view that the EDCAHPS survey relies on the satisfaction of the patients presented in HCAHP scores in ascertaining the quality standards of a healthcare facility. In establishing whether efficiency in the ED has improved, the healthcare facility can conduct a patient satisfaction survey that will offer information on the quality of services and thereby set a good framework for the launch of ED-CAHPS.
Redefining the Admissions Process
The process of admission is critical in ensuring a smooth transition between the emergency department and the inpatient department. As such, it is essential that organizations have an explicit definition of how patients will transit from ED to the inpatient unit. Specifically, Scaletta (2014) states that the transition process should be as discreet as possible. The patients should be able to understand when they qualify for admission and how they will get to the next step. However, Kilaru et al. (2016) opine that the physicians and nurses should have parallel tracks that work to ensure that the admission process is smooth and procedural. Moreover, NHRMC Physician Group (2016) states that it is critical that measurable expectations are set which will qualify or disqualify admission. For instance, a healthcare facility should indicate that critical patients would be admitted immediately while non-critical ones will be admitted within a set number of hours. When the admission process is clearly defined, according to Weinick et al. (2014), the launch of ED-CAHPS will be successful.
Ensuring Enough Staffing in the Admissions Process
Some of the healthcare facilities have only one nurse who bridges the gap between the emergency department and admission to the inpatient care (The HCAHPS Survey, n.d.). Additionally, they burden this nurse with the tasks of facilitating communication between the various departments as well as completing the necessary paperwork in the transition process. This burden, in the view of Weinick et al. (2014), has the effect of adversely affecting the efficiency of this nurse and hence putting a further delay in the ED. As such, before the launch of EDCAHPS, it is vital for healthcare organizations to ensure that they are adequately staffed. Specifically, Scaletta (2014) posit that the ED nurse should be given a smaller number of activities, which will ensure a quick transition. Instead of performing some operations, increasing the number of staff in the transition process is a way of quickening the process and hence ensuring that no congestion is witnessed in development (NHRMC Physician Group, 2016). Moreover, making certain that the number of staff members required for each activity is present will undoubtedly lead to favorable results when the ED-CAHPS is launched.
In conclusion, the emergency department plays a critical role in the healthcare system through the provision of acute care services. The ED-CAHPS is a survey conducted by the U.S. Agency for Healthcare Research and Quality (AHRQ) to ascertain the quality of services offered and thereby determining Medicare reimbursement. Before the launch of ED-CAHPS, healthcare organizations should improve their patient ED through improved patient satisfaction scores, having a clear and concise admission process, and ensuring adequate staffing in the transition between ED and inpatient care. The critical role of ED makes it susceptible to congestion, which affects the quality of services. As such improving, its operations is essential for the maximum award of Medicare compensations.
Weinick et al. (2014) NHRMC Physician Group (2016) The HCAHPS Survey (n.d.) Scaletta (2014). Kilaru et al. (2016)
Improving Efficiency CAHPS require healthcare organizations to be prepared through improving their efficiency in ED. One of the ways in which efficiency can be improved is through having large reception and patient areas. HCAHPS surveys should be conducted in the quest to ascertain efficiency before ED-CAHPS Healthcare organizations should take steps in improving their ED before ED-CAHPS in done. Patients complain about the neglect of the ED by most of the healthcare organizations, which affects quality of healthcare.
Redefining the Admissions Process The patient experience in the ED should be made better by having a clear admission process. Having a large area for reception in ED is one of the ways of ensuing that the admission process is fast. The patients should be informed clearly of the procedure for admission and get help. Some of the steps hospitals should take are ensuring a well-organized admission process. Patients agree that admission processes make them sick due to their disorganization and lack of protocol.
Ensuring Enough Staffing in the Admissions Process Patients admitted from ED should be given good services in the quickest time possible. Increased numbers of patients require an expansive area and increased number of staff. Patients have a right to be given sufficient service by good staffing and smooth admissions process. The number of staff members in the ED should be commensurate with the number of patients. Most patients agree that the numbers of staff members are not enough and should be increased to match with the increasing number of patients.
Kilaru, A. S., Meisel, Z. F., Paciotti, B., Ha, Y. P., Smith, R. J., Ranard, B. L., & Merchant, R. M. (2016). What do patients say about emergency departments in online reviews? A qualitative study. BMJ quality & safety, 25(1), 14-24.
NHRMC Physician Group. (2016). Emergency Department Opens New Reception, Patient Areas. Retrieved from: https://www.nhrmc.org/physician-group/news/2016/06/ed-reception-and-patient-areas-openScaletta, T. (2014). News: ED-CAHPS Surveys: Take Steps Now to Ease the Future.
The HCAHPS Survey (n.d.). Frequently Asked Questions. Retrieved from: https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/downloads/hospitalhcahpsfactsheet201007.pdfWeinick, R. M., Becker, K., Parast, L., Stucky, B. D., Elliott, M. N., Mathews, M., ... & Kotzias, V. (2014). Emergency Department Patient Experience of Care Survey.
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