...HOW TO USE CLASSICAL MANAGEMENT APPROACH IN UTILIZING ACCIDENT &EMERGENCY DEPA RMENT? BY ZAHRA AHMED EBRAHIM Master in Business Administration General Management Organization and Business Management Open Asia e University 2011 Introduction Background of the Study A number of approaches to the structure and management of organizations developed during the late 1800s and early 1900s .The early philosophies are traditionally labelled classical theory while the later approaches include systems theory and contingency theory. The classical approach to organization focuses efficiency through design. Eleanor and Phillip (2009) kept four elements to build classical theory: division and specialization of labour, chain of command, organizational structure, and span of control. The first element emphasised about dividing the work reduces the number of task that lead to proficiency and specialization. The second element is the chain of command which is meant the hierarchy of authority and responsibility within the organization. However, the collaboration between staff and there managers improve the efficiency and productivity of the unit. Moreover, the third element is organizational structure that describes the arrangement of the work group. The design of the Organization is intended to faster the organization survival and success. Finally, the span of control addresses the pragmatic concern of how many employees a manager can effectively supervise. The later approaches...
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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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...lengthiest of all specialties2The objective of our study was to study the relation between various types of patients admitted in the department of plastic and re-constructive surgery at Sher-i- Kashmir Institute of Medical Sciences,J&K and their respective waiting times.The study was conducted for a period of one year from 1st October 2013 to 30th September 2014.It was a prospective observational study carried out on the patients admitted in the ward of plastic and re-constructive surgery. The study was done based on the interviews from relevant informants, study of records .Out of the total of 2238 patients admitted 495 cases were that of RTA(road traffic accidents), 162 bear mauls, 135cleft palate, 117 cleft lip,99 tin cut injuries,90 PBC(Post burn contracture) hand,72 cases of...
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...A Case Review of EHR Implementation in a Pediatric Emergency Department Jennifer Juif Southern New Hampshire University A Case Review of EHR Implementation in a Pediatric Emergency Department Organizations face many challenges when implementing an electronic medical record (EHR) system. Quality, safety, and efficiency need to be maintained during implementation. The case study reviewed: Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department (Kennebeck, Timm, Farrell, Sooner, 2012) attempted to quantify the effects of offloading low acuity patients and its impact on length of stay. Length of stay and volume of patients in an emergency department are correlated. The study was conducted in a pediatric emergency department (ER) in Cincinnati, Ohio. Prior to implementation, a plan was utilized to off load patients to a different area in the ER due to a surge from the H1N1 flu virus. This was successful in decreasing patient numbers and length of stay. The organization decided to use the same template for the EHR implementation. Despite its prior success, offloading patients did not improve efficiency or length of stay (LOS) during EHR implementation. The primary issue identified was the failure of offloading patients. The study stated, “During implementation only 5% of patients were diverted. During the H1N1 surge, 10-20% of patients were diverted.” (Kennebeck, Timm, Farrell, Spooner, 2012). The...
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...October 5, 2012 Risk Loss, Prevention & Emergency Planning Case Study #3 October 5, 2012 Risk Loss, Prevention & Emergency Planning Case Study #3 Risk Loss, Prevention and Emergency Planning Case Study 3 Disaster preparedness is achieved partially through readiness measures that expedite emergency response, rehabilitation and recovery and result in rapid, timely and targeted assistance. It is also achieved through community-based approaches and activities that build the capacities of people and communities to cope with and minimize the effects of a disaster on their lives. Disaster preparedness is a continuous and integrated process resulting from a wide range of activities and resources rather than from a distinct sectorial activity by itself. It requires the contributions of many different areas—ranging from training and logistics, to health care to institutional development. Viewed from this broad perspective, disaster preparedness encompasses the following objectives: • Increasing the efficiency, effectiveness and impact of disaster emergency response mechanisms at the community, national and Federation level. This includes: * the development and regular testing of warning systems (linked to forecasting systems) and plans for evacuation or other measures to be taken during a disaster alert period to minimize potential loss of life and physical damage * the education and training of officials and the population at...
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...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 PrimaryPlus...
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...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 PrimaryPlus...
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...Organizations (JCAHO) accredited are required to implement root cause analysis as part of their obligation. The root cause analysis team strives to assess and improve patient outcomes as specific situations occur by forming a team of experts that were involved in the situation. Cases are reviewed and processes are implemented to correct the errors that took place. Four key questions are asked, what happened, why did it happen, what can be changed to prevent it from happening again and how are we going to evaluate the change. This process takes place soon after the event so details are not forgotten. The professionals involved in the root cause analysis would take on roles. The team leader would be a representative from risk management. The nursing supervisor that was working on the day of the event would be the recorder. The team members would include the manager of the emergency department, the RN, LPN, and physician involved with the patient from the emergency department. The advisor would be the chief nursing officer or another member of the executive staff. The first thing is to review the many causative factors that were in place on this particular day. There was inadequate staffing for the emergency department for the number and high acuity of patients that were being treated. There was a hospital protocol for conscious sedation that was not followed. The nurse was ACLS and CPR certified. The patient was not fully monitored for the procedure. This would require Mr. B’s level...
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...Effective Emergency Department Treatment of Acute Migraines Grand Canyon University: NRS-433V January 12, 2014 In 2011 a research to practice article was published in the Advanced Emergency Nursing Journal by Patricia Kunz Howard and Susan E. Shapiro on effective acute migraine treatment in the emergency department. Kunz Howard and Shapiro reviewed and critiqued a research study by Kostic, Gutierrez, Rieg, Moore, & Gendron (2010), titled “A prospective, randomized trial of intravenous prochlorperazine versus subcutaneous sumatriptan in acute migraine therapy in the emergency department,” that was originally published in the Annals of Emergency Medicine. The clinical/ research problem that led to this particular study was to find out whether there was a clinically significant difference in two different treatments for acute migraines in the emergency department. Currently pain management for headaches is considered controversial. The Agency for Healthcare Research and Quality is currently evaluating migraine management. This is part of an effective health care program that is focused on providing evidence for clinical providers caring for a specific patient population; an example would be migraine headaches in the ED. (Kunz Howard & Shapiro, 2011) For this study there were 187 patients that presented to the ED with a headache in the study period, 66 of which completed the study. The groups of patients in the prochlorperazine group (35 patients) reported a...
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...On site and offsite emergency plans on chemical disaster Why Emergency Planning is required? After the incident of Bhopal gas disaster, the Factories Act has been amended and a new chapter i.e. Chapter IVA – provision relating to hazardous processes has been added to the Factories Act with addition of new provisions sec 41A, 41B, 41C, 41D, 41E, 41G & 41H covering all hazardous process industries. Under the provision of Sec 41B(4) every occupier shall with the approval of the Chief Inspector of Factories draw up an On-site Emergency Plan and detailed disaster control measures for his factory and make known to the workers employed therein and to the general public living in the vicinity of the factory the safety measures required to be taken in the event of an accident taking place. This is the statutory provision laid down in the act for preparation of On-site Emergency Plan to control disaster in the factories. Major accidents may cause emergency and it may lead to disaster, which may cause heavy damage to plant, property, harm to person and create adverse affects on production. Many disasters like Bhopal gas tragedy, Chernobyl nuclear disaster etc. have occurred at many places in the world causing heavy loss of life and property. Emergency situation arises all on a sudden and creates havoc and damage to person, property, production and environment. Therefore such situations and risks should be thought in advance and it should be planned before hand to tackle...
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...Introduction: Since 1991 when the patient’s charter (Department of Health 1991) was introduced, Accident and Emergency (A&E) departments have been under pressure to see, treat and discharge patients within a certain time period. In 1991 75% of walking wounded who presented to the department had to be discharged within one hour. It was subsequently changed in 2004 when the government decided that 98% of all patients attending an A&E department should be in the department no longer than four hours (Department of Health 2004). And again in 2011 when the department of health introduced the clinical care indicators that relaxed the target to 95% seen, treated and discharged or admitted in 4 hours (Department of Health 2011). Triage nurses within the accident and emergency department are one of the first people to assess the patients who present with an injury or illness. The patient’s condition is assessed and their need for how quickly they require treatment is prioritised. Triage nurses are usually experienced A&E nurses who have many years A&E experience (Dolan et al 2007). Patients are then placed in queues to await assessment by a Doctor or Emergency Nurse Practitioner. Once seen they are then put in another queue to await x-ray if necessary before waiting again to see the doctor/ENP that will interpret their x-ray and decided on the best course of treatment (Ward 1999). Many patients have long waits within the department for x-rays and assessments, and this can increase...
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...Ethics Case Study HCS478 January 6, 2010 Barbara Scheibe, RNC, MSN Ethics Case Study Healthcare professionals are faced with ethical dilemmas and issues on a regular basis especially in the emergency department. The purpose of this paper is to identify ethical issues within a case study. This case study involves an eight month old infant who presents to the emergency department with injuries. After arriving at the emergency department it is noted that the infant has bilateral fractured femurs. The ethical issue identified within this case study is the possibility of child abuse by either the mother or a worker at the daycare facility. The nurse makes notes of her concerns within the patients chart as well as verbalizes concern to the emergency room physician regarding the injuries to the infant. It appears to be a lack of follow-up with these concerns so this presents an ethical issue. There are eight ethical principles that a nurse should learn to apply to each situation that he or she feels there is an ethical decision that needs to be made. The eight principles to apply are autonomy, beneficence, nonmaleficence, veracity, fidelity, justice, paternalism, and respect for others (Guido, 2010). Within the nursing field advocacy plays a critical role in keeping the patients safe throughout their encounters with the health care system (Beyea, 2005). One of the conflicts noted in the situation listed is, more research should have been conducted to investigate...
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...The Impact of Electronic Health Records on Pediatric Patient Flow Elizabeth Dutton September 24, 2014 HCM-500 Healthcare Informatics 4-1 Case Study: EMR Implementation and Patient Flow The goal of integrating to the use of electronic health records (EHRs) is to improve quality and reduce costs, however, these systems experience a number of challenges. Electronic health records are computerized paper charts that allow hospitals and medical facilities to compile patient information into one system. This case assesses the effect of employing EHR on “overall patient length of stay, time to medical provider, and provider productivity during implementation of the EHR” (Kennebeck, 2011, p. 443). While the focal point of these systems is to improve the quality and timeliness of patient care, there are a number of challenges facilities face throughout the implementation phase. The implementation of EHRs faces an assortment of trials within the medical industry. The largest concern regarding electronic systems is the protection of patient information, which is required by law through HIPAA. In addition, Stephanie Spellman Kennebeck (2011) describes the potential difficulties involved with the evolution of electronic medical records, stating, “as EHR systems evolve from first generation computerized physician order entry or simple niche system to large hospital-wide EHR integrated records, the risks of the implementation on impacting patient safety, efficiency, and financial...
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...Case Study Carrol Godwin Southern New Hampshire University HCM 500 1. What if the study had shown the emergency department (ED) was implementing a lab information system rather than an EMR, How would that impact patient flow? Explain. 2. What would have changed if the implementation was planned for the early summer or late spring? 3. What elements are needed in order to ensure patient safety? 4. Depending on your discipline, address one of the following questions (you may respond to both, if desired): As a nurse manager, what would you like to have seen done differently with the implementation? As the office manager, you oversee the staffs who admit patients to both the ED and overflow clinic. What could you have done differently to make the implementation go more smoothly? 5. The next phase of the EMR implementation plan involves the ICU and NICU. What recommendations would you make to modify the implementation plan based on the ED experience? Explain. 6. After reading this case, how will you use the lessons learned to implement your group project? In my case study I will discuss the impact on the workflow in the Emergency Room (ER) when lab information system is implemented. I will discuss any impact on the patient flow thru the ER and the turnaround time (TAT) for lab results and any effects on the patient’s length of stay (LOS). I will discuss patient safety issues and what is needed to insure the institutions goals are met. I will look at the implementation...
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...University Hospital Case study Reference no 609-007-1 This case was written by Professor Dr Paul Gemmel and Lieven De Raedt, Vlerick Leuven Gent Management School. It is intended to be used as the basis for class discussion rather than to illustrate either effective or ineffective handling of a management situation. The case was made possible by the co-operation of an organisation that wishes to remain anonymous. © 2009, Vlerick Leuven Gent Management School. No part of this publication may be copied, stored, transmitted, reproduced or distributed in any form or medium whatsoever without the permission of the copyright owner. ecch the case for learning Distributed by ecch, UK and USA www.ecch.com All rights reserved 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...
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