Waiting Times in Emergency Department, Essay Example

This essay is about waiting time in the emergency department and it is based on my experience. I was waiting in the ER to be transferred to the inpatient hospital for further treatment for serious problem of Pancreatitis after I got all the necessary diagnostic tests and treatments by the emergency nurses and doctors. By the time I was in the ER, I noticed that the emergency department was over crowded and the emergency crew were trying to help every patient but they had no bed to treat any more patients any farther. I was complaining why I was waiting there, when the doctor said I have to be admitted to the hospital and the busy nurse told me that “there is no bed in the hospital and you have to wait here’. Finally I realized that the ER problem does not start there; there are other interconnected issues in the system which has to be addressed. Those issues included; Lack of enough inpatient hospital beds and Shortage of government funding to health care system.

In this essay I will first investigate the situation in inpatient hospitals so as to get the clear statistics why there are shortages of hospital beds. I will discuss this with healthcare professional in charge of the hospital and also interrogate nurses and physicians in charge of inpatient diagnosis and treatment. Second, I will investigate how the government if funding healthcare services and systems by collecting data samples of government statistics on various health systems and analysing the data to drive suitable conclusions.

Issue #1 : Lack of enough inpatient hospital beds.

Patients may wait at emergency department for quite some time because of obvious reasons like triage process. A triage process critically means that patients who are more critical are seen first and less critical ill patients must wait (Keith, Benjamin, Marlene, 2010). This waiting time is normal and some times it is neglected. However, there are critical situations which are observed in the emergency department which need to be addressed. Overcrowding of patients in the emergency department beds that should be in inpatient hospital beds is one such critical issue. Overcrowding means a situation in which the demand for emergency services exceeds the ability of the emergency department to provide quality care within medically acceptable time frame (Laskowski, McLeod, Friesen, Podaima, Alfa, 2009). The major cause of overcrowding is lack of enough beds on hospital wards and intensive care units.

Due to the shortage of hospital beds, overflow patients are often boarded in the emergency department, causing a situation where critically ill patients are blocked from getting medically acceptable on time care. Another cause of hospital bed shortage is acute bed care capacity which is affected by patients who need alternative care. Patients who need acute care and could be served at home are forced to be in the hospital beds due to lack of acute care resources as well as chronic and palliative care beds. These patients occupy up to 20% of hospital bed space and thus act as obstacles that contribute to emergency department overcrowding by hindering the admission of diagnosed emergency patients to inpatient hospital wards. Averagely, one patient boarded in emergency department blocks four patients who need emergency care per hour leading to prolonged wait time and suffering of patients (Burt, & McCaig, 2006).

Issue#2: Shortage of government funding to health care system

Over the last ten years, Canada has experienced a 40% shortage of overall hospital bed capacity due to reduced government funding of healthcare systems. Increased complex patient population, aging, hospital and bed closures all have contributed to overcrowding problems in emergency department across Canada (Burt, & McCaig, 2006).

Studies by the British show that, emergency departments overcrowding scarcely occurs when hospital bed occupancy rates are maintained at 85%, but, overcrowding occurs constantly when occupancy rates are more than 90%. In Canada, most hospitals operate at bed occupancy rate of 95% which is the major reason why there is long waiting times and overcrowding in emergency departments. The Canadian association of emergency physicians suggests that if bed capacity could be restored and healthcare professionals focus on matching the level of care to the level of patients need and on shifting the patients from one bed to the other as per the need, then long waiting times and overcrowding could be largely resolved (Science Daily, June 1, 2011).

Conclusion

From the above discussion, it is very clear that, the problem of waiting times in emergency department does not be gin in the emergency department but it is associated with other external issues. Bed shortage in the hospital wards is the major cause of long waiting times in ED and this can be solved by hospitals taking necessary measures to improve this situation. If nurses examine the state of every patient and work according to each patients schedule time of hospital stay care, they could reduce the number of patients occupying the beds by discharging them in time so as to continue with their care at home. Secondly, the government must support healthcare facilities with enough funds to build more healthcare hospitals and buy enough beds to cater for the increased population of hospitalized patients. Also, the government must employ enough staff i.e. nurses and doctors to handle emergency patients. This will boost the quality and urgent care which will boost patient healing and discharge time to give room for other incoming patients (Keith, Benjamin, Marlene, 2010).

The government should also equip the healthcare systems with new technology facilities so that patients are attended to as fast as possible. This will reduce overcrowding which cause patient suffering, prolonged wait times, deterioration of care services, and even loss of life. Waiting times in emergency department can be reduces to manageable levels if bed capacity occupancy in hospital wards is maintained at 85% by either adding the number of beds or improving health cares services so that many patients get discharged in time to provide space for others from emergency department. Increased government support both in human resources and funds will improve hospital care services leading to reduction of waiting times in emergency department.

 Reference

Burt, C. W., & McCaig, L. F., (2006). “Staffing, Capacity, and Ambulance Diversion in Emergency Departments: United States, 2003-04.” Advance Data from Vital and Health Statistics, no. 376. Hyattsville, Md.: National Center for Health Statistics.

Keith A. Willoughby, Benjamin T.B. Chan, Marlene Strenger, (2010) “Achieving wait tim ereduction in the emergency department”, Leadership in Health Services, Vol. 23 Iss: 4,pp.304 – 319

Laskowski M, McLeod RD, Friesen MR, Podaima BW, Alfa AS (2009) Models of Emergency Departments for Reducing Patient Waiting Times. PLoS ONE 4(7): e6127. doi:10.1371/journal.pone.0006127

Science Daily (June 1, 2011) — Long emergency department waiting times are associated with an increased risk of hospital admission or death within seven days among non-admitted patients, finds a study published on the British Medical Journal website.