The impact of operations strategies for emergency room in Taiwan
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Abstract:
First aid is a primary part in the medical system; however, large-scale medical centers are facing the dilemma of overcrowding. When the number of emergency patients increases over the allocation of manpower and equipment, emergency is likely to be overloaded. Such a dilemma might crowd out the resources for critical patients, seriously affect the emergency service quality, and reduce the morale of staff before the patients being safe.With system simulation, this study establishes an emergency simulation model aiming at the researched subjects to discuss the authenticity of present emergency room. Furthermore, National Emergency Department Overcrowding Scale (NEDOCS), the emergency compound standard, is utilized for evaluating the overcrowding degree in emergency rooms. Two strategies, proposed for improving the overcrowded emergency rooms receiving emergency patients, are also evaluated the effects on the overcrowding degree with NEDOCS. The outcomes show that the proposed strategies could actually improve the overcrowding in emergency rooms.Keywords:
Overcrowding
Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.
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Triage
Emergency medical care
Medical care
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Overcrowding
Emergency nursing
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Overcrowding in emergency rooms (ERs) is a common yet nagging problem. It not only is costly for hospitals but also compromises care quality and patient experience. Our paper provides solid evidence that telemedicine can significantly improve ER care delivery, especially in the presence of demand and supply fluctuations. We believe such findings are critical for ERs, due to the special setting of unscheduled arrivals leading to high unpredictability of patient traffic. Additional evidence suggests that the efficiency gained from telemedicine does not come at the expense of lower care quality or higher medical expenditure, which points to telemedicine as a feasible solution to the ER overcrowding problem. For healthcare practitioners, our paper highlights the general applicability of telemedicine through the “hub and spoke” architecture. Besides increasing patients’ access to more immediate care from specialists who were not available otherwise, telemedicine enables flexible resource allocation for any hospitals, regardless of where hospitals are located. Our research also provides ground for policymakers to incentivize hospitals to adopt telemedicine in ER, which we believe is critical given the relatively low adoption rate, the lack of direct evidence on its effectiveness, and the current inflexibility of reimbursement policies regarding the application of ER telemedicine.
Overcrowding
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Based upon the study on urban emergency system analysis,the simulation technology was used to solve the difficulty of hospital emergency department overcrowding problem.After discussing of the phenomena and causes of overcrowding,and with the understanding of its characteristics,the paper presented the logical structure and mode of overcrowding simulation analysis system,and discussed based on the method and procedure of the system.
Overcrowding
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고품질의 맞춤형 서비스는 사회가 고령화, 초핵가족화, 재난 취약 계층의 증가로 인하여 급격히 늘어나게 되었다. 급성 질환, 심뇌혈관 질환, 자살 등 예방 가능한 사망률이 선진국에 비해 높으므로 빠르고 전문적인 구조 및 구급 서비스가 요구된다. 본 논문에서는 응급 환자가 발생하여 병원에 도착하기 전에 환자의 정보를 이용하여 응급처치가 가능하도록 한다. 그리고 응급 의료 기관에서는 환자 진료 준비를 사전에 갖출 수 있도록 하여 응급 환자 진료의 효율성을 높였다. 사회적 인지도가 높은 119번호를 이용하여 다양한 복합 응급 신고를 접수하고 있고, 유관기관과 통합적 대응 체계를 구축하는 효율적 응급의료서비스 선진화 전략을 제시하고자 한다. High-quality customized services demand was growing due to the increase of aging, extremely nuclear family, disaster vulnerable of society. Ambulance service is required of fast and professional rescue and emergency service because of preventable death rate such as acute diseases, cerebral and cardiovascular diseases, suicides, etc. was higher than in developed countries. First aid will be available using patients information when emergency occurs, before arriving at the hospital. And emergency department is equipped with that patient care can be prepared in advance, increase the efficiency of emergency care. We received a variety of complex emergency call using high social awareness of 119 number and propose an efficient emergency medical service advancement strategy building an integrated response system with relevant organization.
Healthcare service
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Center (category theory)
Emergency rescue
Emergency Response
Emergency rooms
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Overcrowding
Triage
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Emergency nursing
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Center (category theory)
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