Many deaths have been noticed in the emergency departments of most hospitals. Most of them are due to prolonged emergency room wait times and less bed spacing caused by overcrowding patients. Lack of adequate professional and poor patient flow management have also been great contributors.
This article discusses some of the most effective ways hospitals and especially the emergency departments can deploy to improve timelines of the emergency room wait time. But first, lets’ find out more about emergency care.
Background of emergency department care
Medical emergencies can be acute illnesses or injuries posing immediate risks to health or a person’s life. By definition, therefore, emergency care is the process of diagnosing and treating life-threatening conditions that require close medical attention to save the patient’s life.
Examples of emergencies are:
- Heart attack and other heart complications
- Breathing difficulties and chest pain, among other respiratory severe illness
- Severe injuries with bleeding that won’t stop or heavy blood loss
- Mental illness or crisis
Other factors that would help determine health emergency room wait time includes:
- Severe burns and scalds
- Severe allergic reactions
- Deep wounds like in cases of stubbing
When a family member, relative or friend suffers any of the above conditions, you should ensure you rush them to hospital emergency room wait time. But, some situations would require you to conduct first aid and CPR.
Furious patient making call at the emergency reception desk after waiting for long.
The key principles of emergency care
The main objective and goal of the emergency services are to reduce complications and risks of early mortality and improve quality of life. Research has confirmed that early actions influence late mortality to save a life. That makes first aid a fundamental principle of emergency care.
First aid is the first care given to patients upon arriving at the scene or hospitals. In case of emergencies on the scene, the aider should continue assisting the patient until a health professional comes.
However, when it happens near a hospital or a condition one can’t manage, they should rush the patients to the hospital.
Emergency first aid care and treatment are always guided by 3Ps; preserve life, prevent further injuries and promote faster recovery. Most importantly treatment method for the condition would always depend on the type of emergency.
So, first, aiders and professionals must ensure they do no harm, further the injury or do something that would cause unnecessary pain, unless to do otherwise would result in severe complications or death.
Unfortunately, some patients have suffered in hospitals while waiting for services, including basic first aid. And that has been attributed to various factors.
Factors posing a threat to quality emergency room wait time and care
Mostly, the emergency room wait time would reflect the management or planning. And longer wait time would be attributed to poor management and planning. Also, the delays in services at the EDs can be associated with the following factors:
1. Inefficient patient flow
Patient flow is a significant problem affecting most hospitals, including emergency departments. In fact, some EDs would receive more patients than they can handle. That means some patients, especially those with lesser-emergency needs, would have to wait until the patient volumes decline. This affects their treatment plans and may result in more severe complications and death.
2. Inadequate physical space with un-friendly designs
Unlike other-high risk businesses, most hospitals have failed to factor in the human population during the engineering and maintenance of various workplaces. Some hospitals have very few rooms with fewer beds with un-friendly layouts and equipment placement.
The worst case is that some urgently needed equipment like computer tomography (CT) scans ICU rooms are located very far from emergency departments. It would, therefore, force the staff to move patients over several rooms and buildings to get the most needed assistance.
So, less physical space and inappropriate layouts would affect the speed of services in emergencies as patients may take longer to find the fitting room or area for treatment.
3. Inadequate healthcare personnel
Most hospitals have declined to embrace the recommended nurse-to-patient ratio. Sometimes, hospitals admit more patients than their doctors can handle. This has increased patients wait time and reduce the quality of emergency care. When doctors realize they have to take many patients within a shorter period, most will not give a maximum time to all patients.
4. Lack of enough or quality healthcare equipment
Some hospitals and emergency departments have used the same ED services for a long time until they get out of speed and accuracy or efficiency. Slow and outdated equipment hinders the quality of emergency care.
5. Inadequate financial incentives
Most of the hospital operations depend on financial reimbursements. However, the current state of hospital finance support systems discourages healthcare centers from hiring or paying qualified and many staff and purchasing enough facilities to aid the emergencies.
This has made emergency patients compete for services, beds and staff with those patients who might have scheduled for specific elective treatments.
6. Delays in the ancillary services
Doctors would have to perform specific tests and diagnoses for adequate emergency treatment to happen. However, some of these tests would take long before the results come. Most data suggest that most delays and longer wait times in the emergency departments are caused by prolonged tests and screenings of emergency patients.
7. Inpatient admissions obstruction
Inability to move all the admitted emergency patients for the emergency department beds to inpatient beds has proven to be a significant contributor to longer wait times in hospitals. Inadequate beds would force newly admitted patients until other free beds are available. Keeping patients waiting in hallways until others are removed from beds is a poor substitute for quality care.
8. Defensive medicine
Also known as defensive medical decision making, defensive medicine happen when doctors curtail medical services to avoid high-risk medical procedures or patients. Sometimes, physicians would recommend a treatment method or diagnostic that is not the best option but serve themselves against the patients.
Fearing litigation, emergency physicians would subject their patientsto prolonged emergency room wait time monitoring periods or order additional tests. Such activities would only slow the care services and increase patient emergency room wait time.
How hospitals can improve the timeliness of emergency department
To ensure quality care and improve the emergency room wait time, hospital management has to consider the following initiatives:
1. Adequate staffing
Every hospital, especially the emergency department, must ensure they employ a lot of staff to help cover every treatment stage. When there are enough doctors and nurses, there would be high chances for most ED patients to be treated at once.
In other words, it would be hard to notice the high demand of patients when there are people to handle them at every treatment process. This ensures faster services and higher satisfaction levels.
2. Modify your physician staffing
It’s common to find most large emergency departments with more board-certified ED doctors. However, hospitals should pair emergency physicians with internists or family medicine practitioners.
Unlike having few certified doctors or nurses, pairing varieties of profession ensures the ED has options or persons to handle various emergencies. Some would take severe complications while others, depending on qualifications, can manage first aid to prevent further injuries or damages. The multi-cooperation ensures faster and more effective care within the minimal time.
3. Move nurse from triage to direct patient care
Triage is the process of prioritizing patient care, especially during emergencies. It involves attending to patients based on their level of injuries/illness and severity against the available resources.
The truth is, the emergency department may experience many patients with various injury situations. When this happens, sometimes the nurse that would register them would not be the same ones attending to their needs. So during treatment, doctors would still ask them the same questions asked by the nurses at the registration. This consumes a lot of time care time.
To reduce or minimize such effects, ensure to move nursing staff from that triage and make doctors or the physicians the first stoppage or point of contact for emergency patients.
4. Buy quality equipment
Doctors and health nurses at the emergency departments need to be exposed to various complex and modern technology machines. They need faster equipment and can evaluate or screen patients and provide more immediate responses. This would ensure patients get their results in time and get the necessary treatment without waiting for long periods.
5. Timely administration or execution of ancillary services
The screening and treatment procedures would not take much longer with quality equipment. The result and recommendations would be available in time for smooth and prompt hospital patient flow.
Several hospital processes and activities consume a lot of time and reduce emergency room wait time. Factors like delays in the ancillary services and inpatient admission obstruction with inadequate staffing lower the quality of emergency care.
But to improve care, hospitals have to hire adequate staff, buy quality ED equipment, and ensure timely execution of all ancillary services while redeploying nursing staff.