Code Blue Emergent Care
Introduction
For over twenty years, the Mediheal clinic and research facility has served the residents of Houston Texas efficiently by providing adequate medical services and treatment. In the last five years of its service, however, the emergency department wing has been marred with a lot of difficulties. This has led to a general declension in the levels of services offered by the emergency wing of the clinic. The problems have been noted majorly by the increased number of complaints registered daily by the patients visiting the emergency room for treatment purposes. The complaints have cited reduced emergency room management, long wait hours, inadequate patient care, and patients being sent away because of lack of space, staff and physicians to provide appropriate care as some of the challenges facing the emergency room. After a thorough investigation of the complaints, it has been noted with serious concern that they truly are genuine. The emergency department, therefore, seeks to diagnose the root causes of the problem, and find amicable ways of mitigating them. This will ensure the development in the level of service offered by the Mediheal clinic (Kronenfeld, 2002).
Reasons for the complaints leveled against the emergency wing.
After a thorough investigation, the following are the causes leading to the complaints leveled against the emergency room:
There is an increased influx in the number of uninsured Americans and public program employees who visit the hospital. The effect of this is overcrowding in the emergency rooms. This, in turn, leads to an increased number of patients who need to be attended to yet the bed space is minimal. Most of the patients are thus placed on the waiting list as others are treated. The federal law also stipulates that emergency room services are supposed to be given 24 hours a day, seven days a week. This also results to a high record of patients visiting the hospital.
The emergency room mostly operates at its peak capacity of 15 daily. The result is an overwhelming of the emergency medical system. Therefore, it cannot handle the high demand for emergency medical assistance. Trying to manage a high demand can result into an outbreak of natural disaster like pandemic flu(Charlene Harrington, 2004).
There are a considerable number of patients having non urgent medical problems who go seeking for treatment in the emergency room. They, therefore, affect the quality of treatment offered in the emergency room. In comparison, the patients having private health plans record the lowest numbers in the emergency room care(Charlene Harrington, 2004).
The emergency room is under federal law required to provide treatment and care to all patients that come for treatment, whether they are able to pay or not. This clause has led to an increased number of patients in the emergency room. For example, Medicaid and State Children’s Health insurance enrollees use the emergency department approximately four times the rate of privately insured patients and twice the rate of uninsured patients and the Medicare beneficiaries(Garson, 2007).
The current conditions in the emergency rooms degrade the quality of patient care. The patients are put on hold for long periods of time, even amounting to days. When the emergency room is overly crowded, the ambulances are diverted elsewhere, thus losing precious time. In addition to this, there is a worrying shortage, of doctors and physicians to provide on-call emergency services whenever they are needed(Charlene Harrington, 2004).
The clinic’s current state of affairs also contributes to the uncompensated care burden on physicians. Most of the doctors working in the emergency room complain of debts owed to them due to their delivery of medical services as outlined by federal law. Because of this, most of the physicians become negligent. Negligence is a theory of liability as pertains to medical malpractices. In negligence, the physician owes the duty of care to the patient. Instead, the physicians violate the applicable standards of care. The patient, on the other hand, suffers a compensable injury which is blamed upon the physician’s substandard conduct(Charlene Harrington, 2004).
The emergency room deals with the care of patients that have traumatic injuries and severe signs and symptoms of illness. Patients are, therefore, treated on an elective basis where those with life threatening ailments are given preference over the rest.
Apart from an increased number of non-urgent patients, the increased number of patients and trauma and critical illnesses has also led to inadequate services offered by the Mediheal emergency room due to a limited number of medical supplies. The increase in the number of patients requiring emergency services were noted to be mainly due to lack of necessary first aid treatment. For instance, [patients involved in accidents are not assisted with bystanders mainly due to the Good Samaritan law. For the state of Texas, the good Samaritan law has jurisdiction that protects only those who have completed basic first aid training and are certified by health organizations, such as the American Heart Association. This jurisdiction, therefore, prevents bystanders who lack essential first aid training from assisting accident victims, and they, therefore, lose a lot of blood by the time they are brought to the hospital. The bystanders mainly have a fear of assisting the injured because if they die in their hands, for which they can be sued or prosecuted for unintentional injury or wrongful death. This means that most patients die upon arrival at the hospital, or they develop complications even after treatment(Charlene Harrington, 2004).
All these reasons are intertwined in the complaints cited against the Mediheal emergency room. Negligence contributes to inadequate patient care as much as the increased number of non- urgent patients.
Approach to curb the problems in the emergency room
The most efficient way to curb the problems that occur in the emergency room involves the application of a better health care policy. The problems that face the emergency rooms are as a result of outdated state and national policies. The first step, therefore, will involve the amendment of the state laws and regulations on the clauses pertaining to health matters.
The Mediheal emergency department also plans to bring in the health care policymakers to support the hospital officials in re-organizing and restructuring the emergency care economic incentives. The health care policymakers are also required to clarify the roles that should be carried out by the emergency department of Mediheal(W. B. Rouse, 2010).
The emergency department also plans to take a federalist approach as a means of defining the difference between public and private responsibility as related to health matters. The physicians are required to identify their roles and responsibilities. The same goes for the patients. The department plans to sensitize the patients on their roles and conduct as relates to the general procedures to be followed in order to get treated (Harry A. Sultz, 2010).
The emergency department plans to expand the health insurance coverage fast. The expansion of the health insurance cover has been organized in such a way as to attend to the needs of all classes of people, whether they are rich or poor, old or young, literate and illiterate.
The non-urgent patients are going to be moved out of the emergency room and directed to the central wing of the clinic to get treated. This will expand the emergency room space so as to provide for patients with true emergencies that include trauma and rapidly infectious diseases. The reasons for inadequate emergency room management and inadequate patient care are because the expansion of the emergency rooms; to provide for public services and non-urgent treatments only worsen the conditions. There is [poor service delivery whenever there are few resources to attend to many people. The emergency department, therefore, also seeks to increase the emergency wing in terms of volume by expanding the emergency room. It also plans to increase the bed capacity to cater for more emergency patients. The number of medical kits and drugs will also be increased(Kronenfeld, 2002).
The emergency department plans to treat the delivery of emergency medicine as a public safety function, especially in cases of outbreaks such as pandemic flu. In addition to this, the department seeks to amend laws and regulations that hinder the private expansion of the emergency room(W. B. Rouse, 2010).
A crucial strategy that the department plans to initiate involves amending laws and regulations hindering the urgent care for individuals and families seeking treatment, especially in scenarios where physicians are unavailable or negligent towards the needs of the patients. The department also plans to sensitize the physicians on the Good Samaritan laws. These laws are acts that serve and protect those who attend to the ill and injured. The laws are essential as the help reduce bystanders’ hesitation to assist. The department plans to liaise with the state government so as to remove the clause barring unprofessional personnel from aiding victims in medical distress. Those responding to medical distress calls will be defended by the department and be provided with immunity in case there is a liability in the emergency situation(Charlene Harrington, 2004).
The department believes this will help the emergency room to minimize the number of emergency patients; as the people in the state of Texas will be encouraged to perform first aid on accident and disease victims. The Good Samaritan laws should also apply to medical practitioners and career emergency responders. The department, therefore, seeks to encourage the physicians to adopt the laws regardless of whether they are compensated or not(Harry A. Sultz, 2010).
With the expansion of the emergency room and bed capacity, the department also plans to recruit more medical practitioners to attend to the emergency patients. In addition to the medical practitioners, the department plans to increase the number of subordinate staff to attend to matters related to meals, hygiene and management of the emergency room(Kronenfeld, 2002).
All these initiatives will improve the care of patients and the administration of the emergency room. The redirection of non-urgent patients to the central wing of the hospital together with an increased number of physicians and medical staff will curb the complaint of long wait lines. The expansion of health insurance covers will ensure patients are not sent away for lack of finances to be treated and will also ensure the physicians are not negligent but liable to attend to the patients(Kronenfeld, 2002).
Prioritization of emergency services
For the strategy to be carried out efficiently, the department plans to prioritize the levels of emergency services. This not only ensures adequate patient treatment, but also helps to ensure improvement in the overall levels of services offered by the emergency department. The department plans to apply pre-institutional care through the use of the nationwide 911 emergency system. Before a medical condition is treated as an emergency, those calling for assistance will be required to describe the nature of their situation. Traumas, strokes and myocardial infarctions will be given the first priority. Trauma cases shall be handled only by certified emergency physicians. Those that require transfers to bigger medical institutions will be given the second priority. This means that Mediheal ambulances will be warranted to carry only those with severe injuries or ailments that require transfers to better health institutions. Those with intermediate medical conditions will be redirected from the emergency room to the central wing of the hospital where they will be attended to by certified medical technicians. The one having basic medical emergencies will be treated mostly from home by first aiders rather than coming to crowd the emergency rooms(Charlene Harrington, 2004).
The factors that will be considered before diagnosing and administering treatment will depend on the circumstances, the patient involved, and the availability of resources to support them. The emergency service offered will also depend on the medical care service offered, whether it is at the clinic or at home(Kronenfeld, 2002).
The strategy applies mostly to adults as they are conscious of the methods involved in administering treatment. For minors, through the consent of their parents, all treatments will be conducted at the emergency room, without biasness. The treatment will be administered by the emergency medical technicians or emergency physicians, depending on the seriousness of the medical condition. This is, however, conditional as preference shall be given to the adults having life threatening medical conditions like cardiac arrest(W. B. Rouse, 2010).
The emancipated minors will be treated as adults. The methods used for the treatment of adults is the same that will be used for the emancipated minors with the exception that the regulations applied to them will be like those used for minors. They will be attended to by specialists in medical fields related to minors(W. B. Rouse, 2010).
Incompetent adults will be placed under special care of nurses and staff to attend to them, whether they are at home care or in the emergency room. This shall be done under the special observance of a certified medical practitioner(Harry A. Sultz, 2010).
There are instances of those who refuse to consent to treatment. The main reason for their refusal is due to high medical liability premiums and a broken down medical liability system in the emergency department. Besides this, the patients refuse to consent to treatment due to medical malpractices by unqualified physicians. The department, therefore, plans to use traditional medical liability reforms and implementing alternative health reform practices to encourage more people who refuse to consent to treatment to do so. The medical liability reforms will also go a long way to ensure that patients do not lose access to qualified medical practitioners and an advanced and efficient system of health care services (Kronenfeld, 2002).
Conclusion
In conclusion, the adoption of a well-defined health care policy has been recognized as the most effective way of curbing the problems that arise in Mediheal health clinic. An overhaul of the old clinic policies also has been recognized to be an efficient tool to sort out the problem in Mediheal clinic. Finally, the encouragement of patients to adopt the strategies put in place by the emergency department will also go a long way in ensuring proper doctor-patient relationship and offering better health services.
References
Charlene Harrington, C. L. (2004). Health Policy: Crisis and Reform in the U.S. Health Care Delivery System. Jones & Bartlett Learning.
Garson, A. (2007). Health Care Half-truths: Too Many Myths, Not Enough Reality. Rowman & Littlefield.
Harry , A & Sultz, K. Y. (2010). Health Care USA. Jones & Bartlett Learning.
Kronenfeld, J. J. (2002). Health Care Policy: Issues and Trends, Volume 759. Greenwood Publishing Group.
W. B. Rouse, D. A. (2010). Engineering the System of Healthcare Delivery. IOS Press.