Methods of Reducing Patient Wait Times

Hospital emergency room wait times are the talk of the United States right now. Long wait times can contribute to the problems that decrease the quality of our health care system. Emergency room wait times depend on how busy the day is going, how long it takes for each patient to be seen, and how much staff is on duty. Wait times are also based on your injury as well. If you are there for a broken toe versus a head injury, you are going to be seen after the patient with the head injury despite the fact that you were there first. A case study researched and and written by Kevin Tuttle explains a challenge with a mission to decrease the wait times in the emergency room department.

Retailing choices – Patients have several choices to receive services, through the hospital, a clinic visit, and now the minute clinic. Mayo has two Minute clinics’ that are a walk-in center and are used to assess and treat minor conditions, and monitor chronic conditions of patients and no appointment is required. The wait time is usually less than 15 minutes. (Keckley, Ph.D., P. H., 2008).

In order to eliminate the inefficiencies witnessed in many public and private hospitals that serve a number of patients, an integrated approach to handling the daily workload is necessary. There is need for all departments within the hospital to work closely together in ensuring more effective and efficient service deliveries. In this paper, a planned change is going to be carried out involving designing a new system that incorporates all the departments within the hospital. This includes the surgery department, pediatrics department, dentistry department, nursing department, pharmacy departments, laboratory and testing department, X-ray and Physiotherapy departments, Equipment maintenance and Engineering department, Information Technology

A major scandal arose out of Phoenix, Arizona in 2014 that led to many investigations finding that as many as forty patients died while waiting for care at a local VA hospital. (O’Donnel) And since then, there have not been many signs of improvement, In Arizona as well as the rest of the United States United States, on the wait time scandal. Despite billions of dollars and many calls of reform, investigations still show that that some VA facilities still struggle with bettering the wait times for their patients, leading to more death and late diagnoses. Reports conclude that there are over 500,000 cases of extended wait times, including delays longer than 30 days and being put on a waiting list just for an available appointment.

Rio Grande Medical Center is a full service not-for-profit acute care hospital with 325 beds. Most of the hospital’s facilities are devoted to inpatient care and emergency services, but a 100,000-square-foot section of the hospital is devoted to outpatient (OP) services. Of the 100,000-square-foot OP section, the OP Clinic uses 80%/80,000-square-feet, and the remaining 20%/20,000-square-feet are used by the Dialysis Center. Increased patient volume at the OP Clinic has created a need for 25% more space than it is currently assigned. Due to its large size and patients’ need to access other departments the decision has been made to move the Dialysis Center to another location, and allow the OP Clinic to

The hospital that the clinic is attached to is opening a brand new facility and has decided to expand their community support by opening a family medicine clinic that will utilize the hospital resources. The community is a wide range of working classes, low income, poor, and rural families that must travel some distance to reach health care providers. Attracting patients that need primary care and continued health care will drive referrals to the ancillary departments in the hospital. This increases revenue for the hospital.

St. Vincent’s Medical Center, a 501 bed facility located in Jacksonville, Florida, provides general medical and surgical care to the North Florida Region. St. Vincent’s admits over 26,000 patients annually. The average occupancy rate is approximately 84% with the Emergency Department (ED) peeking at 100% for approximately 4-12 hours daily. The hospital is struggling with availability of bed space. This shortage of available beds creates a bottleneck in the ED on high census days. Bottlenecks are created in the ED when there is a shortage of inpatient beds to place admitted ED patients. Thus, patient flow, or throughput, is becoming more and more important.

The additional revenues that were collected due to increase in ICU capacity by 20 beds enhanced the total ED revenues by 10%.4 The efficiency of care delivery is decreased when patients are diverted to other hospitals, they have to wait for long period to receive care or if they are placed on the floors where they do not belong. This is seen often due to delay in discharging patients.3 These delays and inefficiencies are the primary cause of decreased satisfaction among patients, their families, hospital employees, and physicians. They also result in avoidable increases in patient length-of-stay, reduced quality of care, and lost or diminished hospital revenue.3

On average, the guides took 27 minutes to complete. As the results indicate, Hospital A has not implemented some of the recommended practices in the following guides: Computerized Provider Order Entry with Decision Support, Patient Identification, and Test Result Reporting. The total number of these practices are 16 which accounts for 10% of the total recommended practices. Also, there is a number of practices that has been implemented partially in some areas in hospital A. These practices fall into the following guides: Computerized Provider Order Entry with Decision Support, Clinician Communication, High Priority Practice, Organizational Responsibilities, and system interfaces which account for 11% of the total recommended practices. The only guides that hospital A is fully complied with are Contingency Planning and System Configuration guides. The total number of practices that have been fully implemented across all guides is 125 which represent 79% of the total recommended practices.

The BMS is utilized by key players for patient-flow processing, with BMS data incorporating shared decisions and interdisciplinary collaborations to improve patient movement (Tortorella, Ukanowicz, & Douglas-Ntagha, 2013). On the other hand, the IQLCC allows healthcare providers to evaluate and admitted patients to a safe and efficient level of care level according to their severity of illness (“InterQual,” n.d.). As the result, the author intends to conduct a comparative analysis of the BMS and IQLCC to the use of BMS alone on patient flow and reduce boarding

Working in a large academic healthcare facility, such as University of Arizona Health Network (UAHN), one of the top priorities is the safety of the patient. As a nurse in the operating room (OR) the top priority is being the patients’ advocate which includes monitoring the traffic in and out of the room throughout the surgical procedure. In the operating room the need for supplies at the ready is imperative. Every operating room within the facility are restocked on the off shift which in theory readies the room for the next days scheduled procedures, but as in any organization there are times when an unexpected emergency occurs. When these emergencies occur time is of the essence and in the case of an OR the closest available room to

manage demand at the source of referral. The outpatient waiting list is dynamic - the

Jasmin Charles: Essay Why are the waiting times in Public hospital emergency Departments so long? What contributes to this? What are we doing too address this problem?

Patient’s length of stay needs to be accurately evaluated to build a complete and accurate simulation which replicates the real life situation. Using previous data directly would not give us exact time as data has so much variability in it. Hence we used Expert Fit statistical software to make distributions of patients LOS from previous data. Using such distributions gave us more accurate values on patients LOS with no errors. Distribution were made such that they fit the simulation software SIMIO to implement the distributions analyzed in SIMIO. To describe calculated Length of stay for each patients we further explained the analysis of length of stay in detail below and to make it

As can be seen in Table 1 below, the resources causing the long wait times are those that are over utilized, or those that show capacity utilizations greater than 100 percent. The only over utilized resource are the Physicians, who are being over utilized by 21 percent. The other major resources are still underutilized.