The problem or issue
The wait time for most of the patients in different hospitals commences as soon as they get into the doors of the emergency room and does not end until the time when the patients are admitted to the hospital or is discharged (Mcnew, 2014). Decreasing emergency room wait times is crucial as it will help all residents to get the necessary and timely access to the services, which are provided, in the emergency rooms. The reasons for the long wait times are unique and complex every emergency room.
The visit of a patient in a hospital is made of various events called the patient flow. The services include nursing assessment, registration, consultations, physician assessment, treatments, and investigations (Aslan, 2016). A delay in any of these services can result in an increase in the patients wait time, and it may build bottlenecks in the emergency room. The order through which the patients are seen and the maximum period for which a patient should expect to see a physician varies and bases on the urgency and severity of the conditions of a patient.
Explanation of Problem or Issue
Decreasing emergency room wait times applies in the health environment as it makes the patients delay in getting treatment and other services. Additionally, the urgency of the issue affecting the patients may make the other patients wait for them to be served. The emergency rooms are designed in a unique way in the health environment such that they only serve a certain number of patient populations (Mcnew, 2014).
The increase in the number of the emergency patients, which was approximately 136 million in 2011 joint with some significant shortages in the entire emergency system, limits every individual access to timely emergency care. The primary cause of the long waits in the emergency room is triage in which patients are not seen on the first come first served basis (In Globerman & Fraser Institute (Vancouver, B.C, 2013)
Investigation of the problem or issue
In most of the hospitals, patients take long before they are attended. The reason is that the critically ill patients are the ones seen first. Research shows that this strategy practiced by most of the hospital results in an increase in emergency room wait times. In 2011, the patients who have been in New Brunswickers were surveyed, and it was reported that the patients experienced less than four hours wait time. Although this wait time seems to be averagely good, it is behind the national benchmark, which is set by the health professionals. Additionally, research indicates that most of the patients go to emergency rooms on a semiannual basis (Foss, 2014). In New Brunswickers, 42% of the patients were reported to visit the emergency rooms. On the other hand, some of the patients are not usually there for emergencies. New Brunswickers stated that 12% of the patients in 2011 go to emergency rooms when they need care and not when they need a family doctor or Community Health Centre.
The people who care about waiting include the patients, doctors, nurses, and administration. The patients care about the time they take before they are attended to in the emergency rooms. The reason is that they want their time to be valued. Waiting time is significant for the doctors as the less time the patients wait is efficient in the emergency rooms and it makes them too see more patients (Aslan, 2016). Additionally, the nurses are the frontline staff, and the good mood of the patients makes it easier for them to do their jobs. Decreasing the waiting time also shows a positive light at the hospital, which indicates a positive light on the administration, which runs it.
Evidence of Problem or Issue
In 2014, the report provided by Centers for Disease Control and Prevention showed that the average wait time in the emergency room is 30 minutes and the average duration for treating a patient is 90 minutes. Most of the patient's in different hospitals take averagely 30 minutes waiting time in the various hospitals. The changes is an indication that there is an improvement as compare to 2014 when the patients took up to 1 hour wait time at the emergency rooms. However, the patients still take a long time before the physicians attend to them.
Analysis of the long waits in hospitals
Currently, the wait time in most of the hospitals is between 10 to 45 minutes. Although most of the hospitals have employed various strategies to help in decreasing the wait times in the emergency rooms, they have not achieved the recommended time, which is five minutes. In some of the hospitals, the causes of the long wait times are crowding which means that a high number of patients are visiting the hospital.
The above information indicates that the wait time taken by most of the hospitals in different states is between 14 minutes to 60 minutes. Therefore, the issue of wait times cuts across various states in the United States of America. The data was released in 2014. However, in 2007, the wait time in the different type of hospitals was as follows:
The above chart shows that the rural hospitals are least affected by the issue of wait time. The reason is that they do have a high number of patients.
Areas Contributing to Problem or Issue
The emergency physicians are usually committed to offering high-quality emergency care quickly to the patients. However, boarding and crowding do jeopardize the safety of the patients. The rise in the number of emergency patients which was 136 million in the year 2011 limit peoples access to emergency care.
The leading causes of long wait times include triage and diagnosis. In triage, the patients the patients are not served on a first come first served basis. The hospitals usually consider the patients who are critically ill first. Additionally, a triage nurse evaluates the severity of the conditions of the patient when they arrive for them to determine the people who see the physician right away and the ones who can wait (Andrews, 2014). The health care providers usually have some special training which helps them to determine the sensitivity of an injury or an illness. However, because someone is in a waiting room and does not look sick is not an indication that they are not sick.
Diagnosis is another cause of the long wait times in the emergency rooms. The process of diagnosing a medical condition that may take long at times especially when emergency physician rules some of the life-threatening conditions (Aslan, 2016). Some things like medical treatment, blood analysis, tests, and imaging studies like CT scans and x-rays do take time. Even after the emergency physician ruling out some of the life-threatening conditions, they may end up referring the patients to specialists for full diagnosis or work up.
Boarding is one of the leading causes of wait times in the emergency departments. Boarding is the process of holding an admitted patient in the emergency room for some hours or days until such a time when there is a free inpatient bed (Andrews, 2014). Most of the hospitals usually restrict the number of inpatients that are available to the patients admitted from the emergency room. The admitted patients continue to get high-quality care by the emergency employees which prevents them from attending to the new patients resulting in long waits.
Specialists also cause the long waits in the emergency rooms. The patients may have to wait in case the specialist treating a type of injury or illness cannot be located. The emergency physicians are usually available seven days a week and 24 hours a day while other medical specialists including cardiologists, neurosurgeons, and orthopedic surgeons offer on-call backup services when needed (Foss, 2014). An increased number of these professionals may not take an appeal in the emergency room because of concerns on being sued and reimbursement. In other cases, the patients who need the services might be taken to other hospitals for them to get the care they require.
The other causes of the long waits in hospitals include disasters, closures, and staffing. Accidents cause long waits in a way that the surges in the emergency patients that can be resulting from natural disaster, local disease outbreaks, or mass casualty events may tie the resources and staff of emergency room once. Closures occurred when the emergency rooms were decreased while the number of emergency room visits increased (Andrews, 2014). Thus, it makes more patients rely on the few emergency rooms, which cause the long wait for patients. Most of the hospitals plan scheduling and staffing to be heavy from Monday to Friday from 8.00am to 5.00pm. However, half of the patients usually come to the emergency rooms on weekends and evenings.
Solutions to the problem
Some of the solutions that can help in resolving the issue of long waits in the emergency room include relocating the emergency room to a nearby location, creating a fast track area within the current emergency room, adding an advanced technology to the current emergency room, and redesigning the physical layout of waiting area (Aslan, 2016).
Relocating the emergency room to another location is a good strategy as it can increase the effectiveness of the emergency room for the patients and it would result in decreased wait time (Andrews, 2014). It entails the establishment of an independent emergency room away from the hospital. The room will help in serving things like deep cut to a gun shot. In this case, an advanced triage can also be utilized, and it includes the ordering tests for some ailments. However, the capital that is needed to build the room and additional staff required is expensive for most of the hospitals. This strategy is useful as it reduces the overall waiting time for the patients. It can also result in less issue of boarding it enables the individuals with minor injuries to be treated. Unfortunately, this strategy may not be effective because of issues like communication, which may come up if some patients are transferred. There is also need for additional staffing which is costly.
Creating a fast track area in the current emergency room is another strategy they can help in reducing the wait time. It involves the renovation of the current floor plan with the aim of adding a new section in the exam rooms for a fast track area. In this strategy, a new area would be renovated, and it would allow the less critical patients to be seen quickly. It would also mean that the nurses and practitioners would attend to the less ill patients and doctors can only attend to the patients when the need arises (Foss, 2014). Thus, this strategy may decrease the satisfaction of the patients with service provided as they do not get the chance of seeing the doctor.
Having technological changes in the emergency room is another good option of decreasing wait times in the ER. An advanced patient tracking system is entailed in this strategy. It includes having a large digital screen that gives the doctors and nurses the chance of knowing the information of the patients. It will also indicate the status of the patients plus the maximum they can wait so that they are not left unattended for an extended period (Mcnew, 2014). Use of technological improvements is good. However, it requires the training of the staff.
The last option is redesigning the waiting room for it to be more conducive for the patients and the other individuals who may join them. It also entails changing the physical layout and the furniture design. The space in the waiting room should be divided into smaller portions to enable individuals to separate themselves and allow them to have privacy in the space as they wait.
Justification of the proposed solution
The best option that will help in decreasing wait times in the emergency rooms is to add new technology to the current emergency room...
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