Waiting Room Medicine: Has It Really Come to This?

Kellermann, Arthur L.

doi:10.1016/j.annemergmed.2010.05.038

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…Multiple respondents reported operational changes to improve flow and strive for safe care, which may include accelerated diagnostic pathways, fast track, team triage, and technological enhancements of existing processes, alongside alternative space utilization for clinical care. Although suboptimal, the WR may be the only space available to initiate care [13,14]. WR assessments do not overcome nurse-driven ratelimiting steps but can facilitate diagnostic and therapeutic actions not requiring time-intensive bedside tasks.…”

Section: Discussionmentioning

confidence: 99%

Emergency department responses to nursing shortages

Hodgson,

Kwun,

Gorbatkin

et al. 2024

Int J Emerg Med

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Background The COVID-19 pandemic exacerbated the nursing shortage, which is predicted to continue to worsen with significant numbers of nurses planning to retire within the next 5 years. There remains a lack of published information regarding recommended interventions for emergency departments (EDs) facing a sudden nursing shortage. Methods We queried emergency department leaders from the American College of Emergency Physicians to examine the impact of nursing shortages on EDs and to gather real-world interventions employed to mitigate the effects of the shortage. Results Most respondents (98.5%) reported nursing shortages, with 83.3% describing prolonged shortages lasting more than 12 months, with negative impacts such as misses/near-misses (93.9%) and increasing left without being seen rates (90.9%). ED leaders reported a range of interventions, including operational flow changes, utilizing alternative staff to fill nurse roles, recruitment of new nurses, and retention strategies for existing nurses. They employed temporary and permanent pay increases as well as efforts to improve the ED work environment and techniques to hire new nurses from atypical pipelines. Conclusion We report a patchwork of solutions ED leaders utilized which may have variable efficacy among different EDs; personalization is essential when selecting interventions during a sudden nursing shortage.

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Section: Discussionmentioning

confidence: 99%

Emergency department responses to nursing shortages

Hodgson,

Kwun,

Gorbatkin

et al. 2024

Int J Emerg Med

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“…Emergency services have been forced to adapt to congestion, relocating and increasing the number of professionals, optimizing triage, creating rapid health care modules, but despite this, the evaluation and care of many patients iscarried out in waiting room or in the halls. 12 So, if this is current knowledge, why is it only recharged to an emergency and not to other hospital services? The study by Viccell et al reported that the hospitalization services of medicine could collaborate in mitigating overcrowding, treating patients in the corridors and waiting rooms of their services, the authors demonstrated that this managerial attitude is feasible and safe.…”

Section: Discussion:-mentioning

confidence: 99%

Factors Associated With Overcrowding in Emergency Room at Dos De Mayo National Hospital Lima - Peru

Camarena¹,

H.²,

L.³

et al. 2020

IJAR

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Variables and Measurements: Demand was determined. Times in triage, admission, medical care, auxiliary tests and stay were measured to assess the efficiency of the processes. Finally, the existing free beds in hospitalization were determined. Statistical Analysis: Bivariate analysis and multivariate logistic regression were used. P <0,05 was considered significant. Results: The average age of the patients was 48.79 (SD ± 19,50). Demand in these last two years has increased around 1.57% monthly and 18.85% annually. The total care time was 286,12 minutes ± 36.45 (4,76 hours ± 0.60). The increase in demand (input), and the deficiency of health care processes were not associated with overcrowding, according to bivariate analysis (p> 0.05). Contrary, to the output processes, were closely associated with overcrowding according to the multivariate logistic regression analysis. X 2 : 48.46, OR: 18.50, p: 0.00. Conclusions: The absence of available beds in hospitalization of medicine service is associated with overcrowding, it was found that the availability of less than 8 beds / day in hospitalization rooms leads to 80% overcrowding per day/ month of the emergency room.

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“…[16][17][18] Despite such compelling evidence and disturbing news accounts, many hospital administrators continued to turn a blind eye to the problem. 19,20 Adverse economic conditions took a toll as well. When reports of "patient dumping" came to light in the late 1980s, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986.…”

Section: Emergency Care In Crisismentioning

confidence: 99%

“…An ED cannot deliver prompt, safe, and effective care to incoming patients if it is packed with admitted patients who are waiting for an inpatient bed. 20 Hospitals can reduce ED crowding-and improve their operating efficiency-by smoothing elective surgery schedules and using bed-tracking software to facilitate the turnover of inpatient beds. 48 Regionalization In its 2007 reports on the future of emergency care, the IOM recommended that emergency care be regionalized so that patients consistently get the "right care in the right place at the right time."…”

Section: Of Doctorsmentioning

confidence: 99%

Emergency Care: Then, Now, And Next

et al. 2013

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Five decades ago, hospitals staffed their emergency rooms with rotating community physicians or unsupervised hospital staff. Ambulance service was frequently provided by a local funeral home. Beginning in the late 1960s and accelerating thereafter, emergency care swiftly evolved into its current form. Today, modern emergency departments not only are capable of providing around-the-clock lifesaving care in individual emergencies and disasters. They also conduct timely diagnostic workups, provide access to after-hours acute care, and serve as the "safety net of the safety net" for millions of low-income and uninsured patients. But the field's success has led to a new set of challenges. To overcome them, emergency care must become more integrated, regionalized, prevention oriented, and innovative.

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Waiting Room Medicine: Has It Really Come to This?

Cited by 10 publications

References 19 publications

Emergency department responses to nursing shortages

Emergency department responses to nursing shortages

Factors Associated With Overcrowding in Emergency Room at Dos De Mayo National Hospital Lima - Peru

Emergency Care: Then, Now, And Next

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