A woman walks into Los Angeles County hospital with a complaint of abdominal pain. After being checked in, hospital staff sees that she has recently been there three other times for the same complaint. She is seated in the waiting room. She vomits blood and collapses on the floor; her family urgently contacts staff informing them of her problem. They ignore the complaint. The family becomes so panicked they call 911 from a payphone near the entrance, only to find that they too ignore the complaint, telling them that there is nothing that they can do.
A bystander in the waiting room sees the distress and the blood on the floor, he too calls 911, this time the emergency dispatcher chastises the caller and tells him “This line is for emergency purposes only? ” For 45 minutes this woman lays on the floor vomiting blood while hospital staff stands by and housekeeping mops the floor around her. She died soon after. (Ornstien) This is just one of many incidents to illustrate the need for the reduction of waiting time in emergency rooms across the nation.
Although this is an isolated incident that shows gross negligence, similar events that are not as negligent, but just as irritating for patients, happen every day. The “wait” in the emergency room Wright p. 2 is defined as the time between initial triage and being seen by the doctor. The national average waiting time in an emergency room has increased 18 minutes since 2006 despite efforts to reduce the wait. (Press Ganey) The national average this year is 222 minutes; this is 3 hours and 42 minutes. In Utah, however the wait is slightly longer at 4 hours and 5 minutes.
As an employee in a very busy emergency room, I can see both sides of the argument. Hospital staff is over worked and understaffed leaving a large liability and gap in patient care. Patients complain that they are ignored and abandoned. Nurses complain they can’t take care of so many patients. Staff at the hospital often works at over 100% capacity, thus endangering even the lives of the patients they care for due to fatigue and rushing which then causes problems of oversight. Focus is being directed recently to this growing problem of long emergency wait times.
New computer systems have been developed and implemented. New procedures, strategies, and routines have been attempted. New staffing agencies have been utilized to increase the staff on duty, and current staff has been better trained to handle the flow in the emergency room. Yet, most studies seem to leave out one very important factor worsening this epidemic, the issue of funding. Hospital investors and owners are constantly cutting funding for nurses, staff and doctors.
The doctors that I work closely with are forced by administrative funding cut backs to cut their coverage of the ER thus lengthening the wait time even more (Mimnaugh). At the same time hospital administration sets guidelines that push the physical limits of the staff. I have Wright p. 3 personally worked at or with most of the emergency rooms in the Salt Lake area. When asked how to solve this growing problem, most of the staff respond all the same; more money. Administration implies there is no funding, but hospital staff counters that hospitals must hire more nurses, techs, support staff, and most of all more doctors.
With the input from hospital staff and the cooperation in regards to funding from hospital administration, the wait time can be reduced. Reduce the patient to nurse ratio and increase the tech to nurse ratio. There should be no less than one tech per nurse. This would free the nurse from doing medial tasks and increase their availability. They would be less likely to make medication errors due to being rushed, the techs could be starting IV’s, vital signs, and helping the patients feel comfortable and cared for, thus increasing patient satisfaction at the same time.
There could be more support staff in the laboratory, radiology, and other test related departments so that the wait times for test results could be decreased. And finally, by increasing funding for doctors, the waiting time in emergency rooms would decrease significantly by enabling the hospital to staff more doctors during the busy hours of the day. It would allow the hospital to staff additional doctors at night as well. These steps have been taken in some hospitals with great success.
Hospitals have begun to communicate the expected wait times to their patients, one hospital even goes so far as to post waiting room times on the internet in real time, as of July 20 2007 at 19:31 the wait in the 5 hospitals listed ranged between 0 ? 2 hr 40 minutes with the average being about Wright p. 4 40 minutes. In Iowa, some hospitals boast average wait times of less than 10 minutes and have a guarantee of wait times not to exceed 20 minutes, this only happens with increased funding for increased numbers of staff on duty and with the cooperation between administration and staff.
Wright p. 5 Works Cited: Conviction Paper by Dan Wright CJ Cassidy. “Emergency room wait times: how long is too long? ” June 14, 2007 CNBC News. January 25, 2007. http://www. cbc. ca/canada/story/2007/01/25/er-waits. html/ Charles Ornstein. “Los Angeles woman dies on emergency room floor. ” June 14, 2007 JEMs Magazine. Mountain States Health Alliance Web Site http://www. msha. com/ Press Ganey “Emergency Department Pulse Report; Perspectives on American Health Care”. NHA Web site News Article. http://www. nhanet. orh/news/index. htm? topic=details&news_id=767/.