Lesson+2+The+Solutions+Identified

[|Headed to the emergency room? Bring a book]

As everyone is aware, emergency rooms are not the most efficient places in health care. Most patents are forced to wait multiple hours for a chance to be repaired or told to go somewhere else. Grady is no exception to these problems. Triage and PACe are overwhelmed with patents and the current structure is unable to keep up with old (and standardized) times while keeping policy the same. Our group has decided to recommend specific policy changes an in attempt to curb the latencies of wait time:

The solutions indentified are:
 * Have the patients be escorted down from triage by someone other than a PACe unit nurse (a volunteer perhaps). This would ensure that the nurses within PACe are constantly treating patients and having a low turnaround rate.
 * Implement an EHR to eliminate the amount of paperwork associated with the patient’s care. Once intake is completed, the nurse or provider would only have to add in additional comments about the diagnosis. Also, discharge could be as simple as one click.
 * Have providers fill our paperwork as they see the patient in the rooms. This would decrease the time patients must wait for discharge (current system seems to be that paperwork is filled out in bunches of 3-5).
 * Designate a nurse or provider to talk with doctors over treatment. The current system takes a long time for providers to talk with doctors, sometimes it doesn’t happen at all. Alternately, PACe could have a doctor make a stop into different ECC departments periodically.
 * Chart patient seen in a shift amount by shift instead of person. Current charting system discourages competition, and might even increase misdiagnosis or unfavorable patient swapping during shift change.
 * Place Stickers on folders designated for certain rooms. There is currently stickers showing which slot the folders go in but stickers on the folders themselves might help organization during busy times. Moreover, maybe a red sticker on a folder designated for sexual assault victims so these records can be easily found by providers and law enforcement.
 * In the future, PACe could provide a secondary waiting room to free up space while patients wait for lab work. There are few rooms and the current system creates a backlog of an hour or more in most cases.
 * Have the patient’s fill out the detailed patient information while receiving care in PACe care rather than doing so after Triage. This will save a valuable amount of time and free up space in the ECC.

These policies will be tested and analyzed with control data collected from before the implementation. We can then conclude which styles worked and which did not.

According to the hyper linked page from the Los Angeles times, the average wait times for non-emergent care (i.e. PACe) is anywhere from two to 24 hours. This is completely unacceptable. Some reasons for this lag especially in the non emergent area are the continued coverage gaps in the general populations health insurance policy. According to a national survey 17% of emergency room patients are uninsured. This number is up from 15% in past years. This equates to 567,000 extra visits each year. Triage has been an effective tool in the past to separate emergent and non-emergent patients; however shear volume is overwhelming these understaffed departments. Moreover, older hospitals are not properly equipped to handle the influx of patents.

Works Cited:

Kaplan, Karen. "Headed to the emergency room? Bring a book | Booster Shots | Los Angeles Times." //Top of the Ticket | Fort Hood shootings were terrorism, says Senate Armed Services Committee chair Carl Levin | Los Angeles Times//. N.p., 9 Nov. 2009. Web. 9 Nov. 2009. .