In the medical field, the real action starts in the emergency room. Emergency rooms (ER) require different approaches and equipment than other hospital departments. Patients with unstable conditions frequently arrive in the ER, and these are the ones who need prompt medical treatment.
However, many emergency departments are understaffed, overwhelmed, and underfunded. Along with increasing patient admissions in emergency medical care departments, the world faces a major health crisis today, making it even more difficult for ER teams. So, how can hospitals improve their current ER condition? In this article, you will learn the different ways how hospitals could improve emergency rooms to ensure immediate and high-quality patient care every time.
Set Hospital Parking Space Close To The ER
The location of a hospital’s emergency room and its layout are crucial in providing quality patient care. Although the ER structure and the patients’ conditions are not directly related, they can significantly impact ER workflow and patient experience.
Because emergency rooms are mostly sought by patients who need prompt medical treatment, it is only sensible to set the hospital parking space close to the ER. For instance, Idaho Falls Community Hospital has an available parking lot near their emergency room, which is very accessible to ambulance and private cars boarded with patients who require ER services.
Here are the benefits of designing emergency rooms close to hospital parking space:
- Immediate access to ER
- Reduced time delays
- Improved patient mobility
Expand ER Service Offerings Through Telehealth
Hospitals can make specialists available in emergency rooms via telehealth platforms. Because of staff shortages, specialty consultations for emergency providers may not be available or delayed for many hours. Such concern is highly prevalent in remote and rural community hospitals, especially those that are serving an older patient population.
The best solution is to implement an effective telehealth program. Telehealth or telemedicine is an innovative solution to access medical care even if patients are far from the hospital. This type of medical care is suitable for disabled and elderly patients.
This involves using a computer or mobile device, a software program or video calling app, and an internet connection, so doctors and patients can interact together, and determine solutions for diagnosis and treatment.
Telehealth helps boost quality ER services by connecting patients to the right healthcare provider at the right time. For instance, tele-neurology programs provide patients 24/7 access to board-certified neurologists. With telehealth, neurologists use video conferencing and telehealth robots to interview and examine patients from a distance.
These are the advantages of expanding telehealth services in the ER:
- Allows doctors to connect with patients anytime regardless of geographical location.
- Provide immediate solution, even if the patient is at home, through telehealth prescriptions.
- Avoid treatment delays and improve patient referrals to specialists.
- A better collaboration of teams involved in urgent care, with the help of the patient and the surrounding community.
Pursue A Team-Oriented Hospital Process
Wait times, staff empathy, and communication are the most commonly identified problems in the ER. It is understandable that patients who are admitted to a crowded and very busy ER are less satisfied with the overall hospital experience.
The solution to this problem is to develop a team-oriented hospital process that can help improve ER conditions. All clinicians must be involved in creating effective treatment plans for patients to ensure smooth transitions. ER staff should be better integrated. It will help ensure that processes and training are appropriate for all ER patients.
With care integration, it will help:
- Decrease turnaround discharge time
- Reduce transfers out of the health system
- Lower average length of hospital stays
Direct Less Severe Emergency Cases to Urgent Care Services
What are urgent care services? Urgent care clinics provide medical care for sicknesses, injuries, and ailments that require immediate medical attention but are not exactly life-threatening. Urgent care facilities are always available in rural and urban communities.
About 13% to 27% of emergency room visits in the US could be managed in clinics, physician offices, and urgent care centers. For less severe emergency cases, patients can be referred to these healthcare facilities to make room for more patients who really require emergency medical care services or are in life-or-death situations.
The best solution to prevent emergency room visits is to encourage patients to take advantage of urgent care centers. These urgent care facilities are usually found in very convenient locations. Patients can visit urgent care clinics at any time, and would not even endure long wait times.
Virtual visits are also advisable because an ER physician can give immediate solutions to patients’ complaints, preventing a more time-consuming and costly visit to the clinic or hospital. Below are some more reasons why ER services can efficiently improve by referring patients with low acuity cases to urgent care facilities:
- It saves ER bed capacity
- Allows ER staff to immediately attend to life-threatening cases only
- Patients who are referred to an urgent care facility can save from ER costs
Set ER GuidelinesTo Avoid Overcrowding
Overcrowded emergency rooms can overwhelm, not only patients but also healthcare workers themselves. Because of a high number of admissions, ER is considered a toxic workplace for many physicians and nurses. This place can cause burnout and high absenteeism rates in hospital staff. For these reasons, it is important to devise appropriate methods to fix overcrowding emergency rooms.
Below are some recommendations to avoid ER overcrowding:
- Separate ER Registration And Triage: In this way, the registration process won’t impede the clinical progress of the patients.
- Reduce Average Triage Time: Implement rapid medical evaluation in triaging to redirect low emergency case patients to other health care facilities.
- Forecasting Number Of Patients: By predicting the number of patients to be admitted in a hospital, it will help ER managers plan on the best strategy when it comes to patient discharge and transfer. It aims to reduce ER admission delays because of inadequate bed spaces and long treatment times.
- Keep Vertical PatientsAs They Are: For instance, instead of giving intravenous treatment to an ambulatory patient, oral medications can be given with the same efficacy. It will help discharge the patient from the ER sooner and avoid nursing utilization because of intravenous treatment.
- CreateA Clinical Decision Unit (CDU): A 3- to 24-hour CDU can be created for patients who require close observation. Also, it applies to patients needing specific medical services such as dialysis, blood transfusion, and gastric bleeding stabilization.
- Implement Triage Protocol: From diagnostic orders, assessment area, specimen collection, and medical treatment, implementing triage protocols help avoid ER overcrowding.
Redesigning Emergency Rooms For The Pandemic
Emergency rooms are considered the front line of community and hospital-based care during disease outbreaks. However, the COVID-19 pandemic crisis has changed the health care delivery system in the United States, most especially the emergency departments. Because of the infectious nature and high transmission of the disease, healthcare facilities—especially emergency rooms—are overwhelmed with a high influx of patients.
The COVID-19 pandemic has overwhelmed emergency rooms throughout the country. As a result, a shortage of emergency equipment, personal protective equipment (PPE), and mechanical ventilators are being experienced. In addition, the open plans of emergency rooms tend to affect indoor air quality and is increasing the spread of the virus.
Experts recommend that the layout and design of an emergency room should be adjusted to accommodate new protocols for the pandemic. This includes:
- Triaging: Itmust involve identifying and grouping symptomatic patients to limit exposure. Triaging patients can be performed through a call center or website so social distancing can still be observed. Standardizing ER admission criteria is important, particularly for patients who are showing respiratory symptoms.
- Enforcing Safety Protocol: It includes wearing of PPE and screening of patients and hospital staff. This must be followed strictly according to CDC and hospital administration guidelines to avoid further spread of the virus.
- Usage Of Portable Equipment: Use of portable radiographic equipment and other similar devices is encouraged. Stocking of PPE, respiratory supplies, disinfectants, and certain medications is also necessary.
- Protect ER Bed Capacity: It is important to limit patient inflow by triage points. Before directing patients to the hospital, they should undergo triage through a telemedicine visit for proper testing and counseling. Low-risk patients manifesting respiratory signs and symptoms should be diverted to an alternate site, like a medical tent to protect emergency room bed capacity.
- Cleaning And Disinfection: When the ER is being visited by over a hundred persons daily, a two-hour cleaning time for contaminated areas is highly recommended.
- Staff Evaluation: The ER administration should regularly evaluate staff for respiratory symptoms and fever before the start of their shift. Any healthcare personnel with respiratory symptoms or fever should immediately self-isolate.
- Scheduling: The impact on scheduling can be mitigated with additional staff backup. This is done to cover a staff member who ds to self-isolate. Healthcare personnel should be prioritized for rapid-turnaround testing because of its enormous impact on staff availability during this critical time.
Hospitals could improve emergency rooms in several ways. This includes setting them up in a strategic location, such as near parking areas. Emergency rooms can also expand services through telehealth to reduce ER bed capacity and reserve them for patients who really need emergency medical care. For the same reason, patients who are not in life-threatening situations may be referred to urgent care facilities instead.
It is also essential to set guidelines to avoid ER overcrowding. Pursuing a team-oriented hospital process help increase quality patient care in emergency rooms by reducing wait times, providing prompt treatment, and increasing ER discharge rates. During the pandemic, emergency rooms can increase efficiency by readjusting protocols and using portable ER devices.