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Code Blue – Emergent Care

This paper looks at the impact of the behavior of staff and the way it affects the patients. It also looks at the duty of nurses, as professionals, in promoting patients’ health. From this paper, it is clear that patients are actually vulnerable to loss in hospitals. In this paper, the Good Samaritan Law is discussed, where it provides protection for the medical practitioners, who offer emergency services in the Emergency rooms, unless willful misconduct or gross negligence has been proved. This paper will take an in depth look at how the dignity of patients is promoted and threatened by the staff at a clinic or hospital. The treatment strategies are also discussed in the paper. The plan consists of the four parts including the presentation of the problem, goals of the treatment, methods that are to be used in treatment, and the time estimate.

Negligence happens, when a physician fails to give the required care to a patient. Negligence among physicians in healthcare facilities may also result from failure to perform their duties. Liability is the imposed action against a physician for the actions in delivering healthcare. Physicians become liable due to the wrong commitments while offering medical care. Emergency rooms are designed to offer immediate and responsive care for those in need of medical attention. For the patients, who warrant immediate medical attention, arrangements can be made to transport them to other facilities with enough medical supplies and equipment.

Root Cause of Complaints about the Clinic

Complaints and comments from the patients in a healthcare facility help in provision of quality healthcare that people always yearn. It is important for a health care professional to understand problems in a healthcare facility and to develop strategies on how the services can be improved to the public. There is always a need by the management of the healthcare facility to take a proactive approach in addressing consumers’ concerns for useful contribution towards the improvement of healthcare services.

The clinic has a 15-bed treatment facility with registered nurses and licensed physicians as staff. The facility conducts medical evaluation and provides treatment for different injuries and illnesses varying from minor to severe. As the chief operating officer in a 15-bed Emergency Room, we see over one hundred patients on a daily basis. On average, the clinic has one hundred and twenty patients, where only eleven out of fifteen beds are functioning.

The aim of the medical facility is to provide a conducive clinical environment for medical screening, identification of medical conditions prioritizing for treatment purposes, and offering appropriate medical interventions. Being the Chief Operating Officer of the medical facility, one must receive many complaints being the best person that the patients will prefer to speak to. Only a small percentage of people are likely to lodge complaints about their bad experience in healthcare facility; instead, they opt to go somewhere else.

As a Chief Operating Officer, one should pay specific attention to complaints, as they are good in terms of help to improve the safety and quality of services. According to Leach and Smith, “When complaints are lodged by consumers and then addressed effectively, they restore the confidence and trust of the consumers” (Leach & Smith, 2005). Complaints help in promoting accountability and the reporting culture. Addressing complaints is very important, since it drains away negative publicity and comments, while enhancing good reputation of the healthcare facility. To manage complaints in a good way, the principles of natural justice and fairness have to be applied.

Over the last year, there have been numerous complaints from consumers. The root cause of the complaints at the 15-bed Emergency Room healthcare facility results from the inadequate staff at the facility. There is poor management and lack of space at the facility resulting to some patients being sent away. In a healthcare setting there is competition, just like in any other business. Consumers tend to understand the medical practices and services that are offered. According to Goodwin, “Poor management results from excessive investment and inclusion of administrative costs that are wasteful” (Goodwin, et al., 1995).

The healthcare facility has a shortage of staff, and these results in fatigue of the strained workers. Fatigue results in the unproductive work that is dangerous and causes costly mistakes. Moreover, because of the shortage of the nurse staff, the facility has a higher rate of poor patient’s outcomes. By increasing the nurses staffing level and recruiting more nurses, the quality of healthcare at the facility can be improved. As a Chief Operating Officer, it is important to take into consideration nursing staffing measurements that include the nursing hours of patients in a day and ratio of patients to nurse. Staffing at a healthcare facility is an issue of concern, since it affects safety of the patients and the quality of care that is provided. It is, hence, clear that when there is a low level of staffing, there is a high likelihood of adverse outcomes at any healthcare setting.

Strategic Plan for Overcoming the Problems Associated with Emergency Rooms

Staffing levels that are used in a healthcare center should minimize hazards to patients and, in turn, promote safety for the patients. Being in a 15-bed treatment facility with a rapid admission and a shortage of nurses, poses a challenge for effective and safe nursing care. Staff at the hospital has to work for longer hours, because of their little quantity. They have few short breaks, and there is very little time for recovery between the shifts. The dignity of patients is promoted, when the staff at the clinic uses interactive and privacy measures that help patients to feel at ease. It is particularly important for the staff members at a clinic to behave in a manner that promotes dignity through interaction.

To promote staff and patients interaction, staff members at the facility need to behave in a way that promotes respect and dignity to the patients. Staff members are required to ensure privacy in the environment by closing curtains, avoiding intruding in the wards without warning and consent. All the nurses need to reduce bodily exposure and they need to use uniform, which make patients feel comfortable. The activities of the staff need to be of value, show concern and consideration to the patients.

Crowding in the Emergency rooms is the main reason, why patients have to wait. With overcrowding in the emergency rooms, there are high chances that errors will occur. The quality of healthcare services can be looked at in six different dimensions of effectiveness, patient centered, safety, timely, equity, and efficiency. According to Schiller and Voisard, “The quality of healthcare for the patient will be compromised, when patients will be required to wait for the long periods of time before they can be attended by a physician” (Schiller & Voisard, 2004). When patients walk out of the healthcare facilities because of not being attended by physicians, a significant amount of revenue is lost by the hospital. Emergency room crowding can be prevented by improving the flow of patients. A patient flow strategy will reduce the crowding in the Emergency Room.

As a Chief Operating Officer in the healthcare facility, it is good to implement the patient flow strategy in order to reduce crowding in the Emergency Room. The patients flow strategy requires a multidisciplinary team to plan interventions on how to improve the flow. The multidisciplinary team is important, since members in the team will bring different and vast knowledge and perspectives about the problems, causes, and potential solutions to those problems. Members of the team bring in various resources and promote buy in form peers. The team needs to compromise a team leader, technical experts, and a senior leader at the hospital, research analyst, support staff, and nurses from the Emergency department.

The problem of overcrowding in the Emergency Rooms is a wide issue that requires more complex flow strategies that will have impacts even on other departments. For success to be achieved there is a need for cooperation between departments and individuals from outside the Emergency department.

According to Leach and Smith, “Patient Centered care requires healthcare to be delivered in a more holistic, comprehensive, and coordinated manner” (Leach & Smith, 2005). Here the patients partner with the healthcare provider in making decisions regarding their health. Currently, the average waiting time in the Emergency Rooms is three hours and forty two minutes. This is a problem, because an individual’s condition may escalate, while in the waiting room.

There are five practices that can improve the throughput in the Emergency Room. It is important to note that the emergency department is crucial, since it contributes a sizeable portion to the hospitals revenue. It is however, difficult to staff the emergency department, particularly, when the influx of patients is high.

The first step that can reduce congestion in the Emergency Rooms is an incorporation of the demand-to-server model of staffing. This is, where the arrival pattern of Emergency patients is traced, and adjustments are made accordingly. The second step involves getting patients out of the waiting room as soon as possible. The third practice involves adoption of transparency, when staffing models and processes fail. The fourth step involves hiring scribes in order to reduce the documentation responsibilities by the physicians. The final practice involves documenting the important signs, while discharging patients. This is a quality healthcare mechanism that is used to reduce the likelihood of a patient re-appearing at the clinic.

Justify how the “Good Samaritan Law” Affects the Appropriate Treatment of the ER Patients

The Good Samaritan Law affects effective treatment of patients in the Emergency Room. The law grants civil immunity to persons, who administer emergency care in instances, where the act was not willfully. The person, who administers Emergency care in the Emergency Room, is shielded from any form of liability for usual negligence, but can be liable for irresponsible misconduct. The Good Samaritan Law can affect the appropriate treatment to patients in the Emergency Rooms, since different courts in different states base their decisions with the many theories that are available.

A doctor, who responds to an emergency in the hospital, may not be shielded by the Good Samaritan Laws courts, may conclude that patients usually expect a bill after the service has been rendered. According to Belar and Deardorff, “Good Samaritan Law provides protection for the medical practitioners, who offer emergency services in the Emergency rooms, unless willful misconduct or gross negligence has been proved” (Belar & Deardorff, 2009).

Analyze how the Different Levels of Emergency Services (Basic, Intermediate, Transfer, And Trauma) should be Prioritized in the Strategic Plan.

There are various levels of Emergency services that can be provided in a prioritized manner. They include basic, intermediate, transfer, and trauma. The levels are guidelines that are developed by medical directors. According to Leach and Smith, “The level of emergency service serves as guidelines that help in planning, participation, and implementation of emergency services” (Leach & Smith, 2005).

Formulate a Plan to Treat Adults, Minors, Emancipated Minors, or Incompetent Adults in the New ER Organization

In the new Emergency Room organization, a plan can be formulated to treat adults, minors, emancipated minors, and incompetent adults. In order to treat adults in the Emergency Room there is a need for the development of an in-depth assessment, treatment planning, and management of medication, therapy, and education, as an effort to treat adults in the Emergency Room. In an effort to offer treatment in the Emergency Room, the developments need to be comprehensive, and also a customized treatment plans to cater for all the groups.

The treatment plan needs to identify problems, have goals, have clear methods of achieving the goals, and have estimates on the time, by which the goals will be met. The plan needs to be formulated in consultation with clients. According to Ratcliffe, “A plan is necessary for laying grounds for future work, where it can be modified, depending on the kind of client” (Ratcliffe, 1966).

It is important to always include the clients, while developing the treatment plan; even though, it is usually achieved through an informal discussion. In most instances, it is the specialist, who presents the copy of treatment plan to the client. Regardless of how the treatment plan is formalized, it is subject to change, as the treatment continues to progress.

Create a Procedure to Provide Care to those, who Refuse to Consent to Treatment

A patient may refuse to take treatment, because of the right to informed consent. A patient may also refuse to take medication, as a measure to subsidize income during the period, when the patient is ill. Cooney states that, “A patient will refuse to take medication, when they will be forced to extend their time away from work and their ability to support themselves” (Cooney, 1994). There may also be an exception, where a patient could be diagnosed with a terminal treatment. In this case, the patient may refuse to take medication, since they have no chances of recovering whether or not they take the drugs.

It is normally a dilemma for the physician, when the patient refuses to take drugs that are necessary to promote their health. According to Leach and Smith, “In the case where a patient refuses to take medication, the physician is required to choose the undesirable possibilities of forgoing the treatment that is refused, and instead, the treatment is forced on competent but unwilling patient” (Leach & Smith, 2005). It is important to note that forcing treatment has both legal and ethical consequences. In some instances, the decision of the patient is honored, especially of those patients, who fully understand the consequences of refusal to take medication. This may happen where by providing a patient with a dignified death is as important as saving their lives.

In conclusion, as the Chief Operating Officer of the clinic, one’s responsibility involves coordinating complaints and overseeing provision of quality healthcare to the patients. When there are problems in the clinic, information will be there to show, since poor quality healthcare results in morbidity, increased infection rates, and higher rates of readmission.