Ten Solutions for Emergency Department Crowding - Essay Example

? Solutions for Reducing Emergency Department Crowding Memorial Hermann Hospital Introduction Emergency medicine is not an old notion in the realm of medicine. Countries such as the United States of America and Canada have put keen interests on the discipline. Emergency departments of hospitals are now integral parts of hospitals, and it is quite difficult to imagine how a medical center could survive without any such department (Rowe, 2009). However, crowding in emergency departments is on the rise and it is a major concern for medical practitioners and governments in the contemporary world. This paper illustrates how Memorial Hermann Hospital can reduce emergency department crowding, in the Diagnostic Radiology Department. Brief Overview of Emergency Department Crowding The emergency department is comprehensive and multifaceted as well. It offers numerous services including; fast assessment of patients’ conditions, stabilizing patients who portray life-threatening medical conditions and in-depth management of patients, Emergency department doctors, nurses and other stakeholders often face many problems. Patients are usually brought into the department at odd hours, sometimes late in the night. They can also get into the department any time of the day. This increases chances of medical error which in turn have numerous consequences such as law suits. In the past 15 years the society’s reliance on emergency services has grown in an immense way. This outweighs the capacity of emergency departments to accommodate many patients. Consequently, crowding in emergency departments is something that medics are grappling with (Rowe, 2009). The number of patients requiring these services is increasing day by day. However, emergency facilities are not expanding as fast as the number of patients who need them. This has led to a worrying scenario in hospitals. Emergency department crowding has been on the increase in the modern world. It continues to influence medical conferences and meetings since it is a major concern among the global medical care centers. The causes, impacts and solutions to problems of emergency crowding often dominate these meetings and conferences. There is an array of factors that cause emergency crowding and the scenario is different for rural and urban areas. Some of them include misappropriation of development funds and ignorance of medics in handling patients. The Institute of Medicine (IOM) of the National Academies in the United States of America disseminated information about the dire situation in emergency departments through issuance of three reports some years ago. The reports confirmed that the number of patients in need of emergency services outmatched the number of medical practitioners who provide these services in the United States (IOM, 2007). The reports claimed there were some improvements in provision of these services but the service providers were less dedicated to offer the services. According to the reports, emergency care was at the “breaking point” as it could not adequately satisfy the needs of patients. Solutions to Crowding at the Diagnostic Radiology Department The Diagnostic Radiology Department of Hermann mainly offers X-Ray and CT scan services for both children and adults. The hospital is famous in Texas due to its capabilities in handling emergency services and Life Flight system which handles more than 3,000 flights in a year. The department of radiology has various plans, procedures and techniques of handling emergencies but it has not escaped the problem of emergency department crowding. There ought to be some advancement in the emergency departments of hospitals with regard to quality service provision, safety of patients and efficient methods of granting patients the required emergency services. The following solutions can help the department to deal with crowding. Research Research is a remarkably effective way of dealing with crowding. This is a process of arriving at dependable solutions to problems through the systematic collection, analysis and interpretation of data. It is an inescapable concept in medical care since medical services are dynamic and they change as the global climatic, economic, social and political sectors change. There is need for continuous research into the causes of crowding in emergency departments of the hospital. It is important for medical practitioners in the diagnostic department and the hospital to carry out research about this worrying situation. The study will help to understand the causes, impacts and solutions of crowding. The research should involve all stakeholders including the clinical officers and support staff. Everyone in the institution has something to offer in the study, and therefore no one ought to be ignored. The study would look into the following matters; number of emergency patients received in a day, conditions of patients, the time that most patients arrive, and who takes the patient to the hospital. Biomedical research in the areas of acute coronary syndrome and thrombolytic therapy has greatly advanced the activities of medical practitioners (Rowe, 2009). They can deal with the situations before they progress to advanced stages leading to death. Moreover, research into medical conditions like deep vein thrombosis (DVT) has reduced the amount of time spent by patients in hospitals. Therefore, the role of research in emergency crowding cannot be underrated. One can employ tools such as the Cochrane Database of Systematic Reviews and MEDLINE in the research. The database provides information regarding emergencies and professional practice. MEDLINE is used to identify randomized control trials (RCTs) so as to gain further knowledge on interventions that have been used previously to solve emergency cases. It shows the interventions that are successful and those that are a total failure. There are various websites of international agencies that contain information on how to handle emergency cases. Agencies like the Canadian Agency for Drugs and Technologies in Health (CADTH) and the National Institute for Health and Clinical Evidence (NICE) have various websites concerning crowding. The websites contain information about assessments and reviews of patients thereby giving medics an opportunity to look at equipment that have been used in assessment and review. They can gauge the success and failure of this equipment and thereby know the best to utilize. Medics in the department ought to use metrics and scales occasionally to Learn about crowding (Rowe, 2009). Emergency Department Work Index (EDWIN) (4), the Demand Value of the Real-time Emergency Analysis of Demand Indicators (READI), the Work Score and the National Emergency Department Overcrowding Scale (NEDOCS) are all useful in solving the crisis. Awareness Creation Imparting medics with relevant knowledge regarding emergency services is paramount in achieving the best results from an emergency department. Knowledge Translation (KT) is an effective tool of transferring knowledge among medical practitioners (Rowe, 2009). The diagnostic department can use this tool. It ensures that everyone in a hospital setting is equipped with knowledge on how to handle emergency patients and how to stay away from infections arising from patient conditions, especially patients who need emergency services as a result of accidents. Expand Hospital Capacity The number of patients in many hospitals outmatches the bed capacity. Each day patients are taken to hospitals for emergency services that arise from situations such as accidents. Hospitals and medical centers are grappling with the large number of patients that require emergency medical services yet their capacity does not meet this urgent need. The diagnostic department is not an exception. It receives numerous patients per day who are in dire need of emergency services. Most of them are cancer patients. Memorial Hermann Hospital has a bed capacity of about 1000 beds at the moment (Moore, 2011). Therefore, it is difficult for the institution to handle emergency services comfortably, since people visiting the institution come from different areas. This forces the hospital to put inpatients in the emergency department at times thereby leading to crowding. Review Government Policies That Are Unfair To Medical Centers Government policies are relevant in regulating illegal activities and sale of counterfeit drugs in hospitals. However, there comes a time when the policies infringe on the capabilities of a medical center to comfortably carry out its activities. For instance, the AB 394 policy in California which dictates the ratio of nurse to patients as 1:4 is not popular among all hospitals (Rowe, 2009). It reduces employment opportunities and leads to death of patients in the waiting rooms or in wards due to lack of adequate healthcare. It is quite risky to apply this policy in emergency departments as it is a disadvantage to both nurses and patients; nurses are very tired at the end of the day while patients face the risk of death. Texas does not allow the corporate practice of medicine (Moore, 2011). This interferes with autonomy of the Memorial Hermann Hospital as well as the diagnostic department in making decisions. This policy ought to be reviewed. Use the Right Technique to Perform Various Processes At the onset of emergency medicine, computed tomography (CT) was a process meant for serious medical problems such as head injuries (Derlet, & Richards, 2008). Nowadays, it is even offered to patients by doctors, on request by patients. Computed Tomography (CT) scanning is a procedure that combines X-rays and computing logarithms in an effort to capture images of body parts that are infected with a disease. With computing algorithms, a medic can get three-dimension (3-D) images which are better than two dimension images in displaying a fracture. It gives the doctor information regarding size and shape of internal body organs as well as tissues and tumors. Many medical practitioners overuse CT scan in evaluation of health problems. The repercussion of this trend is felt by patients in many health and medical centers. Due to its usage on minor conditions such as migraines and dislocation of tendons, cases of cancer are on the rise. The department ought to do away with the policy of requesting appointments. It has online services for booking appointments and some patients request for CT scans on the internet. This ought to stop due to the risks associated with regular CT scans, some of which are unnecessary. Involve All Stakeholders in Emergency Services Everyone who serves in the emergency department is worthy and requires respect and honor in their work. It is instructive to note that if the support staffs such as cleaners and cooks fail to accomplish their objectives by performing their duties; this might fail the whole institution. Therefore, everyone plays a significant role in the department and should never be undermined (Derlet, & Richards, 2008). It is also pertinent for the department to call upon healthcare givers at home and specialized medical centers to help with recovery of patients. Moreover, relatives play a major role in recovery of patients and they can go home with some patients instead of prolonging their stay in hospital rooms. This would increase the bed capacity for patients with urgent needs for medical services in the department. Medics are directly affected by the scenario and should be at the forefront of solving the menace. The media or press ought to uncover issues of crowding in the departments to expose the activities of different medical centers. Some centers get funding for expansion but the malpractices in the center lead to misappropriation of funds thereby diverting money from its intended purpose. The business leaders should be involved so as to come up with effective plans and policies for running the diagnostic department effectively. Furthermore, the government must come in to review “poor” policies, such as the policy on corporate medicine (Moore, 2011). The public can play a major role of creating awareness regarding the conditions that require emergencies. This can immensely reduce unimportant visits to the emergency department. The church and other religious institutions can play a role of educating the masses on irrelevant visits to the diagnostic department. Find Alternative Solutions to Emergency Services Calls There are some patients who will call doctors or nurses anytime to book appointments for emergency services. Honestly, a patient who is able to converse with a medic and even book an appointment cannot claim to have a pressing emergency case. It is good for medics to avoid sending out ambulances for emergency services with prior investigation of the nature of emergency. This paper calls out to medical practitioners to avoid unnecessary appointments with patients who do not require emergency services. This allows for consultations among nurses and patients in critical conditions. The diagnostic department in discussion must rethink its decision to publicize its contacts. Find Ways of Preventing Diseases and Injuries Some emergency services are truly uncalled for. Many patients going after emergency services suffer from the so-called “lifestyle diseases.” Such diseases include; obesity, coronary artery disease and hypertension or high blood pressure. They are known as lifestyle diseases because they result from lifestyle behaviors such as overeating, lack of exercise excessive consumption of alcohol and eating fatty foods. Some diseases such as bronchitis are preventable but people go on with smoking habits only to call for doctor’s help when things go haywire (Derlet, & Richards, 2008). The people living in Texas and its environs, as well as in the globe, must change these awful habits and behaviors. Memorial Hermann Hospital should advise patients in how to prevent these diseases. Conclusion Emergency crowding is not a new term in the realm of medicine. It has been there since the advent of emergency medicine and it affects stakeholders in the medical center in different ways. Effective elimination of emergency department crowding requires efforts of all people in a country. Unless all stakeholders are involved, any solution to these problems will never see the light of the day. Combined efforts will enhance efficiency in hospitals and medical centers and reduce unnecessary costs in health procedures. Therefore, everyone in the globe must rise to the occasion of dealing with the crowding dilemma. This will enhance sustainable development in the arena of medicine. References Derlet, R. & Richards, J. (2008). Ten solutions for Emergency Department Crowding Western Journal of Emergency Medicine, 9(1) 24-27 Institute of Medicine (IOM). (2007). Hospital-based emergency care: at the breaking point. Washington, DC: The National Academies Press. Moore, K. (2011). Aco Case Study Memorial Hermann: Houston, Texas. Washington, DC: Memorial Hermann. Rowe, B. (2009). Evidence-Based Emergency Medicine. West Sussex: Blackwell Publishing Ltd. Read More