Introduction
An emergency-room is special medical treatment care that normally specializes in providing acute care to a number of patients who visit the hospital without any appointment, either through ambulances or by their own means. The emergency department is a department that is found in all hospitals and also in all primary care centers. The department is very vital to any hospital as it acts very first to save the life of patients who are in critical conditions and cannot queue or wait for a long time. In most cases the department of Emergency room deals with emergency cases such as accidents, which can occur at any time (Dlugacz, 2006).
Authority structure
The emergency room waiting time cannot only be reduce by emergency department alone all stake holders must play their parts and performs their duties with total commitment in order to achieve a meaningful wait time reduction. The boards of directors, plays a major role in ensuring that the wait time is dramatically reduced by ensuring that the department has adequate staff, enough infrastructures, enough and readily available ambulances. These elements are very important to emergency room without them wait time cannot be reduced.
Executive leadership
This group comprises of seniors doctors who are responsible for monitoring performance, budgeting, setting long-term strategies and overseeing day-to-day function of emergency department. The executive advice the board of directors on what needs to be done in order to make the emergency team more effective, also they are responsible for setting down rules and regulation to be followed in the emergency room in order to minimize waiting time.
Quality Improvement committee
This committee comprises of various hospital departments representatives such as clinical personnel, administrative personnel, quality improvement coordinators and risk manager. Their main duties are to monitor various routine activities, evaluate clinical outcomes, reviews incident reports and to investigate on various complains launched by patients concerning the patients care. The committee has to ensure that doctors and nurses have followed the normal routine procedures when attending to patient visiting the emergency department, they also have to evaluate and respond quickly to complain made by patients. The committee has to ensure that the guidelines given by the Executive leadership are followed (Dlugacz, 2006).
Middle management
They are medical staff in a lower lank of management structure. Their main duties are to supervise other junior staff as they perform their duties, offers assistance to nurses and patients and ensure that all day activities run smoothly. They assigned duties to nurses and deploys doctors and nurses to various section of emergency department according to number of patient visiting that section. They have the authority to transfer nurses from one section to the other in order to ensure that patients are attended on time.
Medical staff
Medical staff comprise of nurses, who are responsible for administering medical services to patients. Collecting information and data about the patient, scheduling an appointment, administering medication, verifying insurances and also filling and organizing paperwork for various patients. Medical staff attached to the department of emergency plays a vital role in determining how long a patient will wait in the queue before being attended by the doctor. Therefore, the Medical staff can actually assist a lot in minimizing the wait time in the emergency room. They have to examine the patient needs and make general judgment if his or her case is critical, emergency, a cute or non-acute and advice the patient accordingly. Only patients who are in critical condition and those in need of emergency attention should be allowed to wait in the emergency room, all others should be directed to respective physicians for further treatment and assistance.
Communication of Performance activity outcome
Performance outcome are communicated to the Quality Improvement committee, by the middle managers. The middle managers gather the necessary information from the doctors and nurses then compiles a report and communicates it to the Quality Improvement committee with suggestion that need to be improved in order to make the department more effective in terms of services offered and waiting time reduction.
Educating emergency room staff
In order to ensure that staff attached to emergency department work towards reduction of time spent by the patient waiting for treatment both doctors and nurses need to be educated on various ways to assist and manage different types of diseases or accident conditions that can make a patient seek assistance from emergency department. Nurses should be taken through training concerning the fast aid given to patient in critical conditions and those at emergency state. Time management skills and communication skills in order to enable them act swiftly to reduce time wastage in emergency room (Ransom, Joshi and Nash, 2009).
Plans to reduce waiting time in emergency room and monitoring the effects.
According to Rowe and Eddy (2008), there are about nine elements of time reduction in an emergency department that need to be reviewed and streamline in order to achieve a meaningful time reduction. First, use of a faster tracking system includes prioritization, ambulance dispatch and diversions of 999 calls to a more advanced line. Second, provision of primary care centers is an alternative for emergency cases; it is obvious that ambulance normally brings patients direct to the emergency department by default, thus creating an unnecessary over clouding of patient in this department. Third, use of triage enables nurse to have a brief assessment of patient to determine the time at which he or she will be seen by the doctor and application of co-payment which involves charging patient for full payment for non-emergency attendance (Rowe, Eddy 2008).
Patient is educated through awareness campaign, that is why use of leaflets is necessary to explain to the citizens which conditions are treated in emergency department in order to avoid patient visiting this department when no need. Diagnostic nurses should diagnose patients immediately they arrive in the emergency department. Through diagnosing, patient can be assessed and their cases determined, those that need immediate attention should be referred to the necessary doctors at once without keeping them waiting. Nurses should do their best to avoid any unnecessary admission in the emergency room after examining a patient if the patient does not really need the room. Only those assessed and found to be in critical or emergency state should be admitted into this room.
Bed management is another key area that need to be reviewed in order to avoid over clouding and wait time, patients that are of no need to beds should not be assigned or admitted to bed, only those that have to spend the night in hospital for observation should be assigned bed in the emergency department. If the patient is well enough to leave the room, he or she must be discharged or transfer to other rooms if he or she still needs to be observed for some days. Thus, there will be another vacant room for the other patients waiting to be admitted. Lastly, staffing the hospital management should ensure that adequate number of staff are employed into this department (Rowe, Eddy 2008). This will ensure that each patient is attended to within the shortest time possible.
External entities
A number of entities have a direct effect on polices making concerning the emergency department. For example, Government donates ambulances and employs doctors and nurses in public hospitals to ensure that there are adequate staff in every hospital. Accrediting bodies should ensure that proper training is offered doctors and nurses especially in time management.
Conclusion
In conclusion, it is a duty of all the stake holders to ensure that wait time in emergency department is reduced. If all the stake holders play their parts well, wait time will be dramatically reduced and a great number of lives will be saved.
Reference List
Dlugacz, Y., D. (2006). Measuring Health Care: Using Quality Data for Operational, Financial and Clinical Improvement. New York: John Wiley & Sons. Print.
Ransom, S.,B., Joshi, M.,S., Nash, D.B. (2009). The Healthcare Quality Book: Vision, Strategy and Tools. (2nd ed.). New York: Standard Publishers Distributors. Print.
Rowe, B., Eddy, S. (2008). Lang Evidence-Based Emergency Medicine. New York: John Wiley & Sons. Print.