Overcrowding in the Emergency Room - Essay Example

? Overcrowding in the ER The emergency department is a fundamental organ in a majority of health care facilities and is charged with the uphill task of providing medical interventions for patients who present themselves without prior appointment. The department handles a wide array of illnesses and injuries that are often life threatening and demand immediate attention. However, the emergency room (ER) seeks to relieve the situation through before the patient is referred for specialised treatment in the same or another health care facility. Owing to the unplanned nature of patient attendance, the ER is prone to overcrowding as medical personnel are overwhelmed by sudden influx of casualties. Overcrowding in the ER is highly prevalent across the United States and the situation worsens in times of catastrophic disasters and accidents. The entire population regardless of their age, gender or financial status are affected by crowding in health facilities. Under normal circumstances, overcrowding is believed to occur as a result of a myriad of reasons that interrelated in more ways than one. The lack of adequate facilities in a health care setting limits the capacity of an institution to cater for the needs of the ever-increasing number of patients. A majority of hospitals lack enough inpatient beds to cater for the unplanned patient attendance at the emergency room that may require admission for further management (McNew, 2013). Overcrowding has also been attributed to enormous population growth over the years without the expansion of key supporting social services. Moreover, the ER is considered as a safety net for the uninsured following the economic hardships that have hit the country in recent years. In light of this, it crucial that adequate resolution are put forth in order to avert a looming crisis in the already troubled health sector. Failure to a quick resolution is bound to effect the quality of health care services by causing delays, which may result to loss of life. In addition, staff burnout are common in overcrowded emergency rooms, thus diminishing the quality of care while enhancing patient discomfort and dissatisfaction. As a result, veteran health care personnel shelf ER duties in search of better opportunities in other departments or facilities. This is followed by enormous shortage of on-call specialist, which limits access to primary health care (American College of Emergency Physicians, n.d.). In light of the above few consequences, it is critical that relevant authorities generate a clear resolve concerning overcrowding in the emergency rooms, which should be implemented to the letter. As illustrated, overcrowded emergency rooms provide an opportunity for improvement through properly versed action plans that seek to eradicate the problem by its roots. Based on the management action plan adopted, the main objective maintains as enhancing efficiency in all affected health care facilities. One cannot enhance efficiency without defining and establishing the root cause of the problem at hand. Therefore, having identified the factors that contribute to ER overcrowding, paves way for a systematic implementation of reforms in medical facilities. The action plan hopes to establish policies that are meant to ease the congestion in the ER by providing alternative solutions to cater for the needs of patients. Such policies will see the restructuring of relevant departments within health care facilities in order to accommodate a higher number of patients. In essence, the action plan should empower emergency rooms to handle more patients at any given period. In so doing, the quality of services should improve translating to increased efficiency. The above expectations can be assessed in a number of ways including customer feedback and opinion on the quality of service. Patients or their next of kin will be asked to rate the conduct and handling accorded to them by medical personnel as well as the supporting staff (Travaglia, 2009). This is provides an opportunity to policy makers to note areas that require improvements even after restructuring. While customer feedback serves the ultimate assessment tool, the success of action plan can be demonstrated by observing the flow of patients in and out of the emergency rooms. This is in line with main objective of the plan, which is to ease congestion in health care facilities and especially the ER. A checklist also provides an easy way of evaluating and monitoring progress in the implementation of the action plan. Notably, medical personnel will be part of the parameters under evaluation and therefore, employee appraisals come in handy for the exercise. This serves to motivate the employees to go an extra mile in providing customer satisfaction, which adds value to operations while reinforcing the core purpose, goals, and values. However, the process of formulating a working plan is faced with constrains that cannot be ignored and must be considered. Among them is the time factor, which demands a quick resolution of the problem in hand before further deterioration and subsequent collapse of the ER services. Moreover, implementation of the plan requires enormous resources in terms of funding and labour, which are hardly available. This is bound to slow down the process of relieving overcrowding in the ER department. Also expected the conflict associated with organisational restructuring that generates reluctance to change among health care personnel. While one cannot pinpoint the crowding crisis to a single problem, poor policies with regard to the health care in United States emerge as major contributing factors. Lack of proper policies has seen poor allocation of funds leaving little to serve the health sector owing to misplaced priorities. As such, major health facilities have limited spaces for expansion as the population demands, which leave the available resources thinly stretched (Stahl, 2008). Similarly, cuts in reimbursement from insurance companies limits the terms of service by hospitals. It has been demonstrated that there exist a shortage medical personnel especially nurses, which translates to slow delivery of services and thus congestion. There is a wide list of valid options that can be implemented to provide relief to overcrowded emergency rooms in the country. Among the options, is the adoption of technology in service delivery at the ER, which would link patients’ details with his/her status. In addition, suggested the enormous task of expanding health care facilities with special focus on the emergency department. It would be prudent to establish an internal committee to handle the running of the ER and liaise with the overall management. It is also critical that accountability is enhanced by use of relevant tools in order to enforce duty of care policies. More options that are radical range from provision of on-site intervention for trauma patients to establishment of a medical camp outside the facility to hand excess patients. Moreover, public sensitisation on common ER complaints is required to ease traffic at health facilities for self-inflicted injuries caused by ignorance. Also prudent is the hiring of more medical personnel to cater for the ever-increasing deficit in patient-doctor ratio. The community, through relevant authorities, can push for the establishment of more health facilities in the wake of population increase. As the situation shifts in to utter desperation and considering constrains to the action plan, the above list is greatly reduced to feature immediate necessities. Consequently, it is important to consult with relevant authorities during the planning and subsequent implementation. There is the need to expand and equip available health care facilities in order to enhance their capacity. It is also critical to enhance accountability among medical personnel in efforts to encourage efficiency. Notably, some level of automation is already in place with electronic health record, which need restructuring to incorporate recent technological advances. Owing to extraneous circumstances however, it may be difficult to incorporate all suggested action; nevertheless, the action items can be dropped without any significant consequences to the expectations. Such action items include the on-site intervention and medical camps, which can be made available in times of disasters. With this in mind, a systematic approach is necessary in ensuring the successful implementation of the management action plan against overcrowding in the ER. First, the leaders and policy makers should be on-board with the impending recommendation for the purposes of guidance and unity on the issue. To achieve this, a committee should be established with members drawn from concerned departments including the ER, finance, and others. This serves to include different views on the problem while devolving the managerial task to the affected. Institutions with devolved management systems have the capacity to resolve of crisis within a limited period since they are familiar with all aspects of the problem. This follows employees’ continually involvement in the decision making process, which to increased employee satisfaction (Nelson, 2005). There are numerous problems within the current health care system in the United States among them is the provision of medical insurance that traceable back to lack of accountability. Such deficiencies contribute to defensive behaviour, blame shifting, and cover-up attempts following negative outcomes as each seeks to clear him/herself. It is therefore important that all stakeholders in the health sector remain committed and compassionate before counting their returns. The action plan suggests the establishment of oversight teams whose role revolves around provision of professional opinions concerning areas that need improvement. The team of experts should be included in the process of formulating and implementing policies that concern the health care. With a professional team in place, the second phase can be implemented with the adoption of new approaches to handling and running health care facilities can be implemented. Such approaches according to the suggested action plan, involve the adoption of the lean concept in health care facilities. Lean initiatives in healthcare aim at improving systems within the organisation, which are highly responsive to patient demands and ensure the provision of high quality services promptly. In addition, this approach aims at reducing the cost of operation and enhances profit margins (Lean Healthcare Online, n.d.). Such achievements are attributes of ensuring minimal wastage of resources, facilities and time, which translates to efficiency among the employees. Having introduced new management mechanisms and empowered employees, the next step involves expanding facilities to accommodate more patients. The level of expansion depends on the availability of funds, space among other considerations. Since most health care facilities have limited space to cater for expansion, areas adjacent to the ER can be relocated to provide the much need space. The community should be involved in this phase of the action plan since the society influences how public resources are utilised. It is believed that limited access to primary medical care leads to increased attendance at emergency rooms across the country (Hall, 2006). Therefore, under the expansion of medical facilities, the action plan suggests the formulation of well-constituted policies to establish outpatient clinics. This serves to lighten the burden currently laid on emergency rooms by creating alternatives to patients with less serious medical conditions. References American College of Emergency Physicians (n.d.). Meeting the Challenge of Emergency Department Overcrowding/Boarding. Retrieved from http://www.acep.org/workarea/downloadasset.aspx?id=34350 Hall, R (2006). Patient Flow: Reducing Delay in Healthcare Delivery. New York: Springer. McNew, R. (2013). Emergency Department Compliance Manual: 2013 Edition. Alphen: Aspen Publishers. Stahl, E (2008). Emergency Department Overcrowding: Its Evolution and Effect on Patient Populations in Massachusetts. ProQuest. Nelson, W (2005). An Organisational Ethics Decision-Making Process. Retrieved from http://www.ache.org/ABT_ACHE/EthicsToolkit/Ethical_Decision_Process.pdf Lean Healthcare Online (n.d.). Can Lean Process Principles Be Applied To Healthcare? Retrieved from http://share.pdfonline.com/12d779d0e71c4e57a4ceafd8d67a0ab0/LeanHealthcareOnline.htm Travaglia, D (2009). Complaints and patient satisfaction: A comprehensive review of the literature. Retrieved from http://www.health.vic.gov.au/clinicalengagement/downloads/pasp/literature_review_patient_satisfaction_and_complaints.pdf Read More