ED (Emergency

Department)
JASMINE CALVILLO
PROFESSOR ORTEGA
SOC 1

A brief history.
Before there was an emergency department people would get
medical treatment through scheduled visits to the doctors office or
have a house call. Emergency medicine came from the necessity of
caring for a growing population of patients seeking immediate
medical care for emergency conditions.

The ED
The ED duties are to provide the best patient care. This means
diagnosing the patient and giving them proper treatment as well as
providing excellent and speedy service. It is no secret that the ED is
not able to do a good job at this. Currently overcrowding and wait
times at hospitals are horrendous. This greatly affects the patients
overall care.

Wait times.
In a study done, average wait time from the moment the
patients enter to the time of discharge was 216 minutes
(Hitchcock). That is over three hours long. If it were me I would hate
having to wait that long while I am uncomfortable and in pain. Many
hospitals hold patients in the ED for several hours when inpatient
beds are unavailable. This has become a significant barrier to
specialized inpatient care (Trzeciak, S., and E. P. Rivers). If a patient
is unable to be seen by a specialist for a longer period of time this
increases their risk of greater harm to their health. This puts a great
amount of stress on the physicians that are trying to treat all of the
patients. The long wait times are linked to the overcrowding at
hospitals.

Overcrowding
Overcrowding at hospitals has become a growing problem. It has
been reported that over 50% of hospitals are over capacity
(Barrett). Overcrowding affects several aspects of ED function.
Patients are waiting longer, are having delayed treatment, have
more pain and suffering, and have poor outcomes in general.

Barrett.

Overcrowding (Continued)
Almost all hospitals do not have enough beds to meet patient
demand. In one hospital they only have 221 beds in the ED and
59,000 visits annually (Barrett). That is obviously way too many
patients for that ED to be able to handle. The system in place now
in hospitals are not able to serve and discharge patients in a timely
manner.

Functionalist Perspective
As of now the structure and order for the ED is barely holding
on. There is no stability which is challenging the order in the ED.
The hidden benefit to the lack of a better system in the ED is that
the current system can help researchers develop a better system
that could ease the stress on the ED. Researchers could analyze
what is wrong with the current system and look for improvements.
When a new system is put into play and succeeds at its task then
we will have found order and stability.

Conflict Perspective
As it can be seen in Table 3 when
comparing a private hospital with a
University or county hospital the
private hospital can be seen to have
better results. This is due to the fact
that in private hospitals only a certain
amount of people are able to pay
more and afford the care offered at
those hospitals. This leaves the
masses to go to the other hospitals
because it is more affordable and
causes the overcrowding. The rich
have that luxury of affording
something better.

A new system.
A few different hospitals took it upon themselves to implement a
new system aimed towards providing better quality care. The T
SystemEV ED information system (EDIS) was going to help solve a
lot of problems and it did. Within nine weeks Hardin Memorial
Health was able to reduce total wait time from 216 minutes to 187
minutes which is a 13% improvement (Hitchcock). Bed side
computers with the new system were installed which helped
clinicians access to real time data. The patients status and
tracking board could be viewed from any computer which also
helped nurse and staff communicate about a patient more quickly
and easily.

Conclusion

The ED obviously has room for improvements. At the rate it is

still going there could be an even greater patient risk, wait time,
and overcrowding. A new system, like the one at Hardin Memorial
Health, must be implemented soon at all ED. We do not want the
current system to crash and leave patients and physicians
vulnerable. It is no secret that current wait times are ridiculous.
The ED is not able to do its duties to the best of its ability without
swift change.

Works Cited
1.

Barrett, Lynn, Suzanne Ford, and Peggy Ward-Smith. "A Bed Management Strategy For Overcrowding In The
Emergency Department."Nursing Economic$30.2 (2012): 82.MEDLINE. Web. 27 Apr. 2015.

2.

Emeny, Russell, and Connolly Vincent. "Improved Patient Pathways Can Prevent Overcrowding."Emergency Nurse:
The Journal Of The RCN Accident And Emergency Nursing Association20.10 (2013): 20-24.MEDLINE. Web. 27 Apr.
2015.

3.

Estey, Angela, and Kathleen Ness. "Understanding the Causes of Overcrowding in Emergency Departments in the
Capital Health Region in Alberta: A Focus Group Study."Understanding the Causes of Overcrowding in Emergency
Departments in the Capital Health Region in Alberta: A Focus Group Study. N.p., 20 Nov. 2002. Web. 27 Apr. 2015.
<http://cjem-online.ca/v5/n2/p87>.

4.

Hitchcock, Robert. "Speeding Up The ED Care Process. Three Hospital Organizations Mitigate Overcrowding By
Improving Patient Flow, Processes And Documentation."Health Management Technology33.12 (2012): 6-8.MEDLINE.
Web. 27 Apr. 2015.

5.

Richards, John R., Misty L. Navarro, and Robert W. Derlet. "Survey of Directors of Emergency Departments in
California on Overcrowding."Western Journal of Medicine. Copyright 2000 BMJ Publishing Group, 20 Nov. 2002. Web.
27 Apr. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070925/>.

6.

Trzeciak, S., and E. P. Rivers. "Emergency Department Overcrowding in the United States: An Emerging Threat to
Patient Safety and Public Health."Emergency Medical Journal. N.p., 29 June 2003. Web. 27 Apr. 2015.
<http://emj.bmj.com/content/20/5/402.full>.

7.

Williams, Robert M., Dr. "The Costs of Visits to Emergency Departments NEJM."New England Journal of Medicine.
New England Journal of Medicine, 7 Mar. 1997. Web. 27 Apr. 2015.
<http://www.nejm.org/doi/full/10.1056/NEJM199603073341007#t=article>.