...Economics of an Urgent Care Center in a Market of Emergency Departments One of the contributors to the rising cost of Healthcare can be attributed to the over use of emergency departments (EDs) for non-emergency needs. In the greater Capitol/First/Beacon Hill area there are three major hospitals (Virginia Mason, Harborview, and Swedish) with emergency rooms and no urgent care centers with the exception of Group Health which is restricted to Group Health insurance members. The question I asked myself is, “Why does Group Health have urgent care for their insurance plan members and the major hospitals in Seattle do not.” Urgent vs. Emergency Care A study by the CDC showed that approximately 70 % of emergency department visits can be treated in a typical primary care or urgent care setting and another study by National Center for Policy Analysis demonstrated that only 13% of patients that sought treatment in the emergency department were clinically appropriate. Reasons for non-emergency visits to the ED range from access issues to primary care providers (wait times, no primary care provider assigned, or no insurance) to a lack of knowledge that they could have been treated at an urgent care or primary care setting. There are good reasons to visit the emergency department: * Trauma due to an accident or assault | * A wound that will not stop bleeding | * Shortness of breath | * Vomiting blood | * Chest pain | * Sudden loss of consciousness...
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...Decreasing the Incidence of Non-Urgent Emergency Department Visits in Patients at PrimaryPlus Cynthia D. Schaefer MSN APRN, FNP-BC Maysville, Kentucky An Evidenced-Based DNP Project Report presented to Frontier Nursing University in partial fulfillment of the Degree: Doctor of Nursing Practice September 16th 2016 Dr. Jana Esden Committee Chair Name and Credentials of the chair None Committee Co-Chair (if applicable) Name and Credential of the co-chair Dr. Adit Ginde Content Expert Name and Credentials of the content expert Due in the Registrar’s Office for Graduation September 16th 2016 Decreasing the Incidence of Non-Urgent Emergency Department Visits in Patients at Primary Plus Cynthia D. Schaefer MSN APRN, FNP-BC Maysville, Kentucky Associates Degree in Nursing, Lincoln University, 1995 Bachelor’s Degree in Nursing, University of Missouri St. Louis, 1998 Master’s of Science in Nursing, Northern Kentucky University, 2008 An Evidenced-Based DNP Project Report presented to Frontier Nursing University in partial fulfillment of the Degree: Doctor of Nursing Practice September 16th 2016 Dr. Jana Esden Committee Chair Name and Credentials of the chair None Committee Co-Chair (if applicable) Name and Credential of the co-chair Dr. Adit Ginde Content Expert Name and Credentials of the content expert Due in the Registrar’s Office for Graduation September 16th 2016 Abstract Title: Decreasing the Incidence of Non-Urgent Emergency Department Visits in Patients...
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...Decreasing the Incidence of Non-Urgent Emergency Department Visits in Patients at PrimaryPlus Cynthia D. Schaefer MSN APRN, FNP-BC Maysville, Kentucky An Evidenced-Based DNP Project Report presented to Frontier Nursing University in partial fulfillment of the Degree: Doctor of Nursing Practice September 16th 2016 Dr. Jana Esden Committee Chair Name and Credentials of the chair None Committee Co-Chair (if applicable) Name and Credential of the co-chair Dr. Adit Ginde Content Expert Name and Credentials of the content expert Due in the Registrar’s Office for Graduation September 16th 2016 Decreasing the Incidence of Non-Urgent Emergency Department Visits in Patients at Primary Plus Cynthia D. Schaefer MSN APRN, FNP-BC Maysville, Kentucky Associates Degree in Nursing, Lincoln University, 1995 Bachelor’s Degree in Nursing, University of Missouri St. Louis, 1998 Master’s of Science in Nursing, Northern Kentucky University, 2008 An Evidenced-Based DNP Project Report presented to Frontier Nursing University in partial fulfillment of the Degree: Doctor of Nursing Practice September 16th 2016 Dr. Jana Esden Committee Chair Name and Credentials of the chair None Committee Co-Chair (if applicable) Name and Credential of the co-chair Dr. Adit Ginde Content Expert Name and Credentials of the content expert Due in the Registrar’s Office for Graduation September 16th 2016 Abstract Title: Decreasing the Incidence of Non-Urgent Emergency Department Visits in Patients...
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...Wee-Care Urgent Medical Website Plan 1909 Oak Bluff Trail Austell, Georgia 30122 770-942-3199 weecare.com Monifa Mwangi January 4, 2011 Executive Summary One of the top complaints of individuals seeking non-critical emergency services is wait time. For emergency room visits, a patient may spend 2-3 hours in an emergency waiting room for non-critical treatment such as fever, cough, sprains, etc. Quick2treat is an online concept developed to allow consumers access to WeeCare’s current office wait times and allows the patient to schedule an appointment, or hold their place in line for urgent care treatment. Once the patient has confirmed the appointment time, the patient is guaranteed to be seen within 15 minutes upon arrival. Internet registration for non-life threatening emergency department services that allows patient and family to avoid dreaded time in a waiting room. The concept of Quick2treat follows current technology for real-time online status reporting used by the airport industry, amusement parks “fast pass” system and online reservation services in restaurants. The market indicates that there is a significant need for quality “urgent” care other then emergency services provided by area hospital’s emergency rooms. Currently, the clinic employs competent, well-educated physicians and support staff to respond to the current needs of patients, however, there is room for growth. WeeCare has developed an excellent reputation with many of patients, through...
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...for sickness or injuries that could have been prevented or treated at home. Although use of the ED for non-urgent and preventable conditions appears to be common and growing, identification of these conditions remains imprecise. One study attributed all of the increase in total ED visits between 1997–1998 and 1999–2000 to visits classified as semi-urgent (care required within 1–2 hours), non-urgent, or no/unknown triage (Cunningham , 2006). Another study, however, found that 6 percent of patients triaged as non-urgent were later admitted as inpatients (Young, Wagner,Kellerman, et al, 2006). Doctor Gordon director of the NB hospital ED physician suggested that, “People need to be educated on particular symptoms, because most of time sickness or injuries could be treated at home. Increasing hospital capacities force people to come to the ED for basic health care and a waiting period that can exceed up to six hours”. According to the ACEP (American College of Emergency Physicians), emergency department visits in 2009 rose to 136 million, up from 96.5 million in 1995. At the same time, the number of emergency departments decreased by 9 percent resulting in dramatic increases in patient volumes and waiting times at the remaining facilities. . In this situation, it fair to say that overcrowded emergency departments pose a threat to the access to emergency care for the public in general, insured and uninsured. A successful solution to this problem will...
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...that are newly graduated or new to the ER setting. My topic is specific for my intended audience and is beneficial for them. This presentation can be easily altered to address nurses that will be working in a pediatric ER. Significance: The ability to correctly triage a patient in an ER is crucial to patient safety and patient care. In a busy ER patients generally have to wait to be taken out of the waiting area. A triage nurse needs to be able to sort through the patients and decide who the priorities are. The intended audience will become the nurses making these decisions. Thesis Statement: Research shows that a 5-level triage system is best practice because ESI and CTAS provide dependability and reliability and because the implementation of a standardized ER triage process improves patient care. I. First Main Point: A 5-level triage system is best practice because ESI and CTAS provide dependability and reliability. A. Previous triage systems broke levels down to Emergent, Urgent, and Non-Urgent. These previous systems had less standardization then the 5-level ESI system. B. Chart reviews revealed that there was rarely any correlation between triage acuity assignments and patient...
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...Qui utilise les services d’urgence et quels sont les temps d’attente?, 2005 ISBN 1-55392-678-1 (PDF) Table of Contents About the Canadian Institute for Health Information . . . . . . . . . . . . iii Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii About This Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Data Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 The Role of EDs in the Canadian Health Care System . . . . . . . . . . . . . . . . ....
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...Response to Stephen Covey’s The 7 Habits of Highly Effective People I am lucky to have chance to read and learn the book of Covey’s 7 Habits of Highly Effective People, which is about an approach to personal and interpersonal effectiveness that includes principle-centered, character based and “Inside out”. According to critical analysis and demonstrate, the author tries to help people to find and cultivate maximum human effectiveness especial for an effective leader who wants to lead and take shape a wining organizations. Firstly, Covey explains the definition of habit that is the intersection of knowledge, skill and desire and 7 habits need to be paid more attention. As the writer’s said “7 habits move us progressively on a continuum form dependence to independence to interdependence.” In the meanwhile, different habit cope with different aspect and habit 1, 2 and 3 are collectively referred to as private victory and habit 4, 5 and 6 concern on public victory that deal with teamwork cooperation and communication. The last one is the habit of continuous improvement. In the following content, I am going to introduce the influence on me for each habit and how to apply them to my real social life. Habit 1: Be Proactive According to the analysis of Covey, he points out that habit 1 actually is the ability of control and initiative, which human beings can manage specific environment rather than dominate by it. I have same feeling to his opinion as there are many kinds of circumstances...
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...Focus Questions 1. Based on the above data, what are the primary values that Helen holds? It seems that Helen puts value on patient’s socioeconomic status and does not want to be bothered with patients who may be more work for her to take care of. Based on the information given above, she avoids patients who are in wheelchairs and only chooses to care for patients who are well dressed. 2. How do Helen’s values regarding time, patient compliance, and patient’s socio-economic status influence her nursing care? Helen may not understand that patients may not want to be non-compliant but may lack the resources and support to make their appointments. The patient may want to come to their appointment but may not be able to drive themselves to be...
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...Transforming an Electrophysiology Practice To Impact Timeliness of Care Studies of the U.S. healthcare system have indicated that timely access to appropriate providers improves the delivery, quality, and outcomes of care. Conversely, delayed or limited access contributes to patient/provider frustration, poorly coordinated care, unnecessary emergency room visits, and potential increases in the burden and cost of disease. A recent high-profile crisis in health care focused on prolonged and unfair wait times at Veterans Health Administration (VHA) facilities that led to potentially preventable morbidity and mortality. In response to this, the Institute of Medicine (IOM) was commissioned by the VA to understand experiences and opportunities throughout the nation related to the scheduling of and access to health care. In a very recent publication from October 2015, the IOM summarized their findings and established that inappropriate scheduling practices are a systemic problem across the entire nation and called for an end to arbitrary scheduling standards, for more transparency, more accountability, and for more attention to be paid to the “corrosive culture” that led to the manipulation of data in the system (1). The report also concludes that opportunities exist to implement enhanced practices and strategies. Appropriate Access To Care Within 48 Hours has been identified as one of the top priorities of the Spectrum Health System. To measure access, Spectrum Health uses...
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...sit down to home cooked meals, or exercise and really take good care of themselves. Fast food restaurants are replacing the home cooked meals and providing bigger portions on their menus and people not finding time to exercise. Instead, they choose to sit down and watch movies at home or surf the net as a source of entertainment due to economic reasons. Children are playing video games instead of playing sports or riding bikes (Obesity in America: What’s driving the epidemic?, 2012. 02). This is becoming a harmful trend which is contributing to the rise of chronic diseases. Obesity does not discriminate and studies over the years have found that there is a significant difference in obesity by ethnicity and race and it differs by sex and age. Obesity is a major contributor of heart disease, cancer, liver and gallbladder diseases, sleep apnea and respiratory issues, depression, infertility, erectile dysfunction and mental health conditions (Jacobson, 2000). In the past 20 years, obesity has risen in the United States and continues to rise with more than 35.7 % of the adults and 17% of children between the ages of 2-19 years of age suffering from obesity today. Studies have shown that obesity affects differently between the ethnic groups, males and females and the higher and lower income brackets. Between the Non-Hispanic Blacks, Mexican Americans, Hispanics, and Non-Hispanic Whites, obesity is higher in Non-Hispanic Blacks (49.5%) as opposed to Mexican Americans (40.4%)...
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... and the responsibilities of public health include assessment, policy development, and assurance (Stanhope & Lancaster, 2012). Goals for public health are to promoting healthy status of the community as well as maintaining the community in a balanced healthy environment. The nurses who are employed by either private agencies or government departments to promote community health are the public health nurse. The public health nurse is to serve the community as the client by using the population-centered practice to seek beneficial health changes for the whole community (Stanhope & Lancaster, 2012). While working in a community-oriented nursing practice, it is important to work with the community partnerships like professional groups or non-medical groups to help promoting community health. The community that the student conducted the windshield survey is in the city of San Gabriel, Southern California. The City of San Gabriel is home to a population of more than 42,000 with a diverse population of Asian, Hispanic, Caucasian, and other ethnic groups (San Gabriel City, 2014). The selected family in the survey has been living in San Gabriel city for about ten years, and their two young children are attending school in San Gabriel Unified. The house of the Wang family is located in a quiet street with easy access to the freeway and stores. The neighbors are majority Cantonese...
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...Health Center is a non-profit clinic serving the uninsured, underinsured ,and underserved population. While they mainly focus on comprehensive primary care as well as education, translation and trasnportation(42 U.S.C. 254B (b) (1). Community Health Centers treat every patient within the community service area even if they don't have the ability to pay . They are also mandated to have a governing board of directors which is made up mainly from active patients and others in the community. Federally Qualified Health Centers are funded in many different ways. The first way is through federal grants under the Health Center Program and Public Health Service Act. They can also be funded from local and state funds . They do receive prefenetial Medicare and Mediciad reimbursement but the fee schedule is a sliding scale based on income. Community Health Centers are the safety net provider for a multitude of people and is the largest network of safety net primary care providers. Community Health Centers have also benefitted from the American Recovery and Reinvestment Act of 2009 which gave $2billion to CHC's over two years which resulted in serving 2.1 million new patients. Following the passing of the Afforrdable Care Act, more focus was shifted to primary and preventative care. The goals of imporving access and quality to care will be focused through community health centers to create a more effficient system. By creating more access to primary care services, health care costs will decrese...
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...Change Management in Action Planning and implementing change in healthcare: a practical guide for managers and clinicians Nadia Gittins and Simon Standish HLSP Institute Why What hat If W How September 2010 Who About tHiS bookLet contentS This booklet is aimed at senior clinicians and healthcare managers who would like help in thinking through, planning and then implementing changes to their healthcare services locally. It provides practical assistance in a way that assumes no prior theoretical background to what is often called ‘change management’. Introduction The Why of change The What of change 3 5 8 10 14 16 17 the booklet is based on HLsP’s experience in supporting individuals and organisations in several countries including nigeria and Russia. Most recently, HLsP designed a successful change management programme conducted for over 400 Iraqi clinicians, administrators and policy makers during 2007-2009. the aim of this programme was to assist participants to become Agents of Change in re-establishing their healthcare system1. there is a wealth of tools and techniques to help with planning and achieving change. Based on HLsP’s experience, the team refined the approach and focused on the tools that really help clinicians to formulate, sell and negotiate their vision of change, and then to plan for successful implementation. the tools presented in this booklet are the ones that clinicians and managers participating in change management programmes...
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...Luckily, our system has Suzie Que with alot marketing expertise. Even though she is new to our company, it would be very essential for me to speak with her in regard to her suggestions and concerns. I would get a feel about her experience and what kind of new patient initiatives we can implement to engage with parents. Since she is working on patient recruitment, it is very important that we highlight the importance of established patient care and patient loyalty. We would need to set up a meeting to discuss and try to create a transparency program where patients understand that their healthcare is the most important. Suzie suggested the TQM methodology. Suzie and I would plan out methods where we can implement strategies to gather patient satisfaction data. We would have to divide metrics into sections. Examples would consist of waiting time, call back reliability, quality of customer service, and physician response rates. We would examine these metrics and look into what we could improve on heavily. From a marketing standpoint, it would be a good method to reach out to patients that had calls with us to rate the quality of their service. The total quality management initiative...
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