The Emergency Department

The emergency department (ED) is one of the sections of the healthcare that receives a wide number of patients within any particular day. Majority of the people who end in the hospitals, about 70% of them get there through the emergency department. People visit the ED for various reasons ranging from minor routine checkup to severe and chronic complications. However, regardless of the number of people seen in these areas of the healthcare, the ED is often understaffed thus leading to slow service delivery and poor quality (DelliFraine, Langabeer & King, 2010). Although all emergency departments serve similar purposes to the patients, each department has problems and complexities unique to its setting. Improving the quality and the safety of operation in the emergency department would require the stakeholders to analyze and understand the specific dynamics of the industry. Having a clear understanding of the various mechanisms used to serve the patients and the complications that are likely to occur in the healthcare setting provides a better platform for the policy makers to device a change improvement plan. Additionally, the emergency department does not work independently. The ED works in conjunction with other areas of care such as the hospital and community based organizations (Woods, Reintjes, & Nagy 2014). Understanding the connection of these organizations can help in the development of a viable change plan to improve the quality and the safety of the emergency department.

Based on the state and national requirements, the ED is failing in three main areas. After the analysis of the patients and the decision of the doctor to admit them, the period taken by the client in the emergency department before leaving for the impatient room is longer that that set by the state and the national standards. Similarly, the average time taken by the patient in the ED before leaving the visit is longer than the set standard by the state and the nation. Lastly, the time taken before a patient is admitted in the inpatient section of the hospital is longer than the set standards. Reducing the amount of time that a patient takes in the emergency department can help in the improvement of quality and safety in ED. Achieving this change will require one to employ different models of change such as Kotter’s theory, to achieve the required transformation in the medical setting. Change is of paramount importance in every organization that seeks growth and development (Neumeier, 2013).

To reduce the general amount of time that patients spend in the emergency department, one should seek to achieve coordination among the different people who offer various services in the ED. Activities in the ED are characterized by small events that make up the patient flow. Encouraging coordination between the nurse who makes first contact with the patient, the physicians who assess the patients and the person responsible for offering treatment can help in reducing the amount of time spent in the emergency department (Woods et al., 2014). Further, communicating clearly to the members of the department and showing them the benefits of working in a coordinated way can help to sell the idea to different people and achieve the intended change. The core desire of every person working in a medical or healthcare field is to see improved health for the public (DelliFraine et al., 2010). Therefore, showing the members the possibility of this happening within their department through benchmark with organizations that have established a similar model can help in achieving the change and inculcating the same to the department’s culture.

To reduce the amount of time taken before the patient is transferred to the inpatient after analysis, the ED should focus on the external factors such as the process used in the hospital to clear bed and provide enough room to accommodate other people. Further, the ED should seek to work together with such departments as the x-ray room and the lab to ensure that the flow of patients from one department to the other is effective. Communicating the need for this change to the staff and removing barriers that hinder coordination between departments can go a long way in achieving this change (Neumeier, 2013).

Lastly, to reduce the amount of time taken by the patient in the ED before they are admitted in the inpatient can be achieved by reducing the number of constrains that make it hard for the staff to perform their duties with effectiveness and by ensuring a close coordination between the department and other organizations. Using community based organizations as an alternative to ED can also help in the reduction of workload placed on the ED staff (Woods et al., 2014). Further, the ED must ensure that it has enough resources to take care of the high number of patients. These changes can be achieved through effective communication within and without the department to ensure that all the people involved in the quality improvement plan understand the value of the process (Neumeier, 2013). Further, employing the use of technology in the emergency department can help in the reduction of errors that occur when analog data is lost during patient flows.

The emergency departments are important medical settings and they should be well equipped to handle the high number of patients that seek their services. Coordination between the department and other institutions is one of the most effective ways of improving the quality of care in the ED.

References

DelliFraine, J., Langabeer, J. & King, B. (2010). Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs. Western Journal of Emergency Medicine, 11 (5), 479–485.

Neumeier, M. (2013). Using Kotter’s Change Management Theory and Innovation Diffusion Theory in Implementing an Electronic Medical Record. Canadian Journal of Nursing Informatics, 8 (1 & 2), 1-12.

Woods, R., Reintjes, S. & Nagy, P. (2014). Quality Improvement Projects Based in the Emergency Department. JACR, 11 (4), 423-424.