...Overcrowding in Emergency Departments across the Country Overcrowding in Emergency Departments Abstract: Emergency departments (ED’s) are considered a necessary component in the health care system. Many patients have access to this department 24 hours a day and 7 days a week. There has been an increasingly large volume of emergency room visits by both adult and pediatric patients up to 43% within the last 5 years. The overuse of the ED’s medical services across the nation is commonly referred to as “overcrowding”. One major cause of overcrowding is the misuse of the emergency room. Another cause is the increased volume of illness. The third cause of overcrowding is a shortage of staff. These major issues can delay staff from providing care to those who need it most. Although staff gives priority to patients who have a higher acuity of illness these patients often have to wait long periods of time before a bed becomes available. Overcrowding is serious issue in the ED and most of the contributing factors are beyond the control of the emergency department. The first cause of overcrowding in the ED is the misuse of the emergency room. More than 50% of emergency room visits are for non-urgent concerns and over 46% of these medical complaints could have been solved by a primary care physician (PCP). PCP’s sometimes fail to properly communicate with their patients which can lead to the anxiety that sends the patient to seek assistance in the emergency room...
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...Quality Research Article Critique Factors Influencing Emergency Use of Nurse Practitioners: A Critique Problem and Purpose This is critique of a Qualitative Nursing article, the article is: Factors Influencing the Decision to Use Nurse Practitioners in the Emergency Department by Laurie A. McGee, MN, ARNP and Louise Kaplan, PhD, ARNP, published in Journal of Emergency Nursing, Volume 33, Number 5, October 2007. The problem that is stated in the article is there is a growing and serious problem facing the overcrowding of emergency rooms within the United States. There is a current epidemic of the population that relies on emergency room care as primary care. “The 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) reports an 18% increase in the number of visits to emergency departments from 1994 to 2004.” This causes long wait times and may cause emergency room doctors and nurses to be overworked allowing for a possibility for mistakes to handle the volume. “Overcrowding is defined as a situation in which demand for emergency services exceeds the ability of a department to provide quality care within acceptable time frames.” Overcrowding can delay care which is a patient safety issue and can lower patient satisfaction. “The Joint Commission on Accreditation of Healthcare Organizations' review of sentinel events has attributed patient deaths to delays in patient care. In hospital emergency departments, delay of treatment is the most common type of sentinel event.”...
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...Overcrowding in the Emergency Department Abstract In this paper I discuss how holding patients in the Emergency Department (ED) has a negative effect on patients. To many patients in the ED , medication errors and patients lingering in the ED instead of being in the Intensive Care Unit (ICU) are the main cause of mortality and morbidity. For this assignment, I gathered information to figure out if the increased number of patients in the ED, medication errors, and the length of time ICU patients are held in the ED at Ohio Valley Medical Center (OVMC) is an actual issue that is effecting our patients. After doing a complete assessment and gathering the needed information, a plan will be put together to cut back on the issues that are causing the morbidity and mortality. Overcrowding in the Emergency Department seems to be an issue that is rising. To many patients are being held in the ED and this is affecting the care of our patients. Overcrowding in the ED and medication errors are occurring because patients are being held in the ED for prolonged periods of time. When these patients are held and the ED has more patients than it should, their is not enough staff and the patients are not getting the care they should. Most of these patient’s are critically ill and need one on one care which is not the option in an overcrowded ED. When a department is to crowded, it leads to delayed care and poorer health outcomes. Overcrowding...
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...Emergency departments throughout united states face overcrowding, the challenge is due to the high demand for services, an increasing number of visits, overuse and misuse of services, and escalating healthcare costs. All hospitals follow a triage system to cope with overcrowding. When there is overcrowding, that will result in longer wait time for treatment, lengthens door to provider time, increase in number of patients leaving ED before treatment, and diverting ambulances to another facility. “Boarding” of patients is one of the main issues in emergency departments and ultimately impacts the service and quality of care patients receive. Emergency department is the front door of the hospital and is the actual revenue generating center of the hospital. Today's entire healthcare revenue cycle has shifted from a provider-to-insurer paradigm...
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...Emergency Room (ER) overcrowding has become a big issue within the healthcare industry. Many people had high expectations that the Obama Affordable Care Act would help reduce the high volume of patients seen in the Emergency Departments. Instead, ER visits have increased. Although Obama Care has increased healthcare services within the medically uninsured and underserved populations through Medicaid and Medicare programs, this community of people tends to utilize the emergency department as a form of primary medical care, and most of these visits are not actual emergencies. In fact, ER visits are costlier compared to routine primary care visits, and the high cost of ER visits affects hospitals tremendously, a hospital cannot turn away patients....
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...4 HSA 515 Organization of a Health Care Facility As a chief operating officer, you are responsible for a 15-bed Emergency Room (ER). You have received many complaints within the last year regarding inadequate patient care, poor ER management, long wait times, and patients being sent away because of lack of space, staff, or physicians to provide appropriate care. Diagnose the root causes of the complaints about the clinic. In a 15-bed Emergency Room (ER), overcrowding of patients is the root cause for inadequate patient care in the ER. The increase in patients throughout the years with limited staff has become an issue for emergency rooms. The increase in patients is created by the increase in the number of aging population with chronic medical conditions and increasing number of uninsured or underinsured patients that go to the emergency room for everyday ailments. Due to the limited number of resources, the emergency room can not maintain an adequate number of physicians, nurses, and support staff to accommodate and care for the number of patients. Overcrowding not only creates long waiting times but also increases risks of medical errors. The physicians are over their capacity which can lead to undue stress and burnout, which in turns leads to poor and inadequate treatment to the patients. Due to the overcrowding, the ER physician will not have the capacity to fully treat, evaluate, and monitor the patient. With the shortage of staff, the waiting...
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...Improving Emergency Department Throughput Time HCS/587 October 1, 2012 Improving Emergency Department Throughput Time Hospitals are experiencing patient congested emergency departments. At Baptist Memorial Hospital, the increase in patient volume and limited capacity contributes to long length of stays and patients leaving without being seen. As a result of overcrowded emergency rooms, patient length of stay becomes more important. Throughput times in the emergency department (ED) play a substantial role in patient and staff satisfaction. Length of stay in the ED is directly related to patient volume, patient acuity, lab turnaround times, and time to treatment, which is all connected to patient satisfaction. Long wait time contributes to patients leaving prior to a medical screening examination. Patients who leave without been screened is dangerous and sometimes deadly, thereby creating a liability for the hospital. Baptist Memorial Hospital has outgrown its current capacity creating overcrowding and delays. Hospital capacity is an organizational barrier faced by Baptist Memorial Hospital. Patient presentations over the past several years have increased substantially as well as an increase in hospital diversion and a decrease in overall patient satisfaction. The current ED operates out of 11 beds with one around the clock physician and a mid-level provider during peak times. Nurse to patient ratios are 4:1 with a dedicated charge nurse. The department also...
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...[PROBLEMS IN THE EMERGENCY DEPARTMENTS OF PAKISTAN] ADVISOR: MR OMAR AZIZ BABAR GROUP MEMBERS: ABSHAM MEHBOOB (08-0014) AGHA MUREED AHMAD (08-0636) HAMZA AHMED JALAL (08-0282) NABEEL ATIQ SYED (08-0141) SYED ALI HAIDER SHAH (08-0176) SUBMISSION DATE: 07-05-2012 This project is solely the work of the author and is submitted in partial fulfillment of the requirements of the Degree of Bachelors of Business Administration EXECUTIVE SUMMARY Our FYP project is based on the issues in the emergency department of health sector of Pakistan on which we are conducting a research work. As we hear about the problems that occur in this department of health sector and the difficulties that people face we will be looking into the depth of these issues and try to highlight the key points that create such a situation. Our main objective is to find the gap between the perception and reality. We go about in our project first giving a brief introduction of the emergency department of health sector according to the secondary data that we collected. We also discussed the techniques, strategies and standard operational procedures i.e. SOP’s according to which emergencies should operate. Moreover we also discussed emergency ethics that are the first and foremost base to determine how the doctors are expected to behave with...
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...allows me to see both sides of the prison system. Prison's in American are very over-crowded due to crimes being committed more often than what they were ten years ago due to not being staffed properly, not having enough room for all the inmates, and the system just trying to have you do your time and not trying to get you back to society. Prison Overcrowding has so many issues understaffing can lead to security and control difficulties. It can also cause heath and the well-being of the inmate’s problems. They will have more violence and conflicts because they are understaffed and cannot be watched properly. Not enough security can make it harder to manage the prison. They can increase opportunities for exercise, sports, and church. Active inmates are less likely to feel stressed or hostile. We can also classify offenders due to the level of their risk and their crime. Improve organization and train inmates on basic sanitation and personal hygiene. As the need for living space increases the space available for educational, jobs, and church is often reduced or taking away completely. We could use volunteers, train the staff on basic skills on communication, being respectful, anger management, and being able to control a conflict. To help with the issue of overcrowding we...
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...Printed in UK and USA North America t +1 781 239 5884 f +1 781 239 5885 e ecchusa@ecch.com Rest of the world t +44 (0)1234 750903 f +44 (0)1234 751125 e ecch@ecch.com 609-007-1 CASE STUDY VLGMS-0903-C Access blocking at Ghent University Hospital Prof. dr. Paul Gemmel and Lieven De Raedt One sunny morning at the end of September 2006, Dr. Paul De Meester, professor of healthcare management at Ghent University, was invited for a meeting with the CEO and the Chief of Medicine of Ghent University Hospital. Professor Van Dijk, the CEO, and Professor De Clercq, the Chief of Medicine, were concerned about conflicts between the hospital’s emergency department (ED) and some of the internal nursing departments (INDs). They showed Dr. De Meester a letter from Dr. Peter De Ridder, the chief emergency physician. Dr. De Ridder did not understand why the CEO had communicated a message about the low occupancy rate of the beds in the hospital, although he had been confronted for some years with the phenomenon of access blocking in the ED. In his letter, Dr. De Ridder further indicated...
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...United States Department of Health and Human Services: As our country struggles through tough times there is no doubt we, as a whole nation, have had to make some compromises. One of the biggest, broadest issues our country has been facing is the recent budget cuts in numerous different categories including mental health care. Mental health care has gotten the short end of the stick in the last few years, and it has become a spiraling problem in the United States. Between 2009 and 2011 the United States witnessed some of the largest state budget cuts in history, and we are still suffering from the consequences of doing so. Where does a majority of homelessness, suicide, substance abuse and jail overcrowding stem from? If you take a closer look it will become very clear that cutting the funding for mental health research and treatment has left these mentally ill patients with very few options suitable enough for their varying conditions. Due to the lack of appropriate facilities needed to properly diagnose and treat mentally ill patients, jails are becoming overcrowded and homelessness is at an all-time high. The importance of mental health care is being put on the back burner while, instead, it needs to be a priority and that is why President Obama’s proposition to increase funding to aid the mentally ill in 2014 is extremely necessary. As states cut mental health care funding, prisons are becoming an asylum. There is a very common misconception among the general public...
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...health care you must start to understand it from its core. The mismanagement of health care has resulted to long wait times and made it the biggest political issue facing Canadian health care (Rachlis, 2005). Wait times in Canada has become a major issue in the health care system and a major set back in providing good quality health services to Canadians. Along with addressing the issues of wait times I will also include the problems of packed emergency rooms, what exactly these wait times are and how it can improve. When ill or in pain, there is nothing more frightening or frustrating than having to wait for treatment. Many Canadian face long wait times for health services such as waiting to see a specialist, having a transplant or simply getting a check up at their local doctor office. Wait times in the Canadian health care system has become a problem for Canadians, despite polices which states equal access to health care, this is not true. It was stated that there is two types of wait times, surgery, MRI, CT wait times and emergency room (ER) wait times (Service Ontario, 2008). Patients suffering from cancer, double transplants for example all end up all getting wait listed and not being able to get the treatment they need right away. It has been reported by CBC that wait times for referral to a...
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...care clinic is a retail-based clinic (RBC) or not, and if it is a physician’s office. The out-of-pocket cost that a patient pays is the sum of the paid amount towards the deductible, copay and coinsurance for each claim. Research has found that the RBCs out-of-pocket cost is lower than physician offices, but nonretail-based clinics out-of-pocket cost is higher than physician offices. This was due to the lower cost rates of laboratory testing at RBCs or the higher reimbursement rate for insurers for providing lower cost of care. Urgent care clinics out-of-pocket cost may be higher due to their ability to provide additional care than a physician office. The cost of visiting an urgent care clinic was found to be less than a visit to the emergency room (Wong, et. al.,...
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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 at...
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...decision-making processes * applying consistent school-wide rules and consequences that are: * collaboratively developed with students and the broader school community * clearly explained * positively enforced * rewarding of good behavior * providing pastoral care for students * maintaining a physical space, including cyber environment that maximizes staff and student safety * supporting staff wellbeing. Good facilities appear to be an important precondition for student learning, provided that other conditions are present that support a strong academic program in the school. A growing body of research has linked student achievement and behavior to the physical building conditions and overcrowding. Physical Building Conditions Decaying environmental conditions such as peeling paint, crumbling plaster, nonfunctioning toilets, poor lighting, inadequate ventilation, and inoperative heating and cooling systems can affect the learning as well as the health and the morale of staff and students. Impact on student achievement * Students...
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