Emergency Department Crowding Case Study

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Emergency Departments (ED) all over the country struggle with over-crowding, and consequently long wait times (WT), extensive length of stays (LOS), high rates of patients who leave without being seen (LWBS), and poor patient satisfaction. This paper will explore the impact of overcrowding and the implementation of a fast-track area (FTA) as a solution to minimize the consequences.
Emergency Department Crowding
ED crowding is a national problem. The number of patients visiting EDs is growing rapidly. According to the Centers for Disease Control (CDC) there were approximately 136.3 million ED visits in 2015, which is 112.7 million more that in 1993. Only 11.9% of ED visits result in hospital admission (Centers for Disease Control and Prevention [CDC], 2016). With high volumes, and low admission rates, EDs all over the country are challenged to seek solutions to this real, moral, ethical, and logistical dilemma. To seek solutions, one must understand the associated costs, degree of compromised care, the ED in question, and current patient flow process.
Cost of Crowded Emergency Departments
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They compromise patient safety, and result in long wait times, extended LOS, poor patient satisfaction ratings, decreased employee morale, and cause many patients to leave without being seen. Those who leave without being seen are at increased risk for harm (McClelland, 2015). Additionally, the financial implications for ED overcrowding are costly, and there is an increased liability. To receive full Medicare reimbursement, hospitals will soon have to report median time from patient ED arrival to ED departure, patient door to diagnostic evaluations, and patients who left without being seen to the Center for Medicare and Medicaid Services (CMS) (McHugh, VanDyke, McClelland, & Moss, 2011). Furthermore, community trust is compromised when an institution cannot deliver appropriate and timely

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