Table
of Contents
1) Abstract
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . 2
2) Introduction.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .3
3) Literature
Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . 3
4) Methodology. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . 6
5) Discussion.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .. . . . 9
6) Recommendations
and Conclusion . . . . . .. . . . . . .
. . . . . . . . . . . . . . . .. . . 11
Abstract
Emergency
Departments are of great importance because they help in dealing with the
patients round the clock. The increasing pressure on the hospital and the
health care departments can be lessened due to efficient working of emergency
departments. Australia as well as other countries are suffering the
overcrowding of patients in emergency department. The ED’s need to be efficient
enough to cope up with the maximum number of walk-in patients as to decrease
the stress on health care workers. Threatening emergencies are to be catered
immediately by the emergency department. No compromise on the patient care is
to be guaranteed by the emergency departments. Sub-Urban ED’s should be
introduced in order to cater the huge number of patients available. The
proposed methodology for this article is to introduce multiple emergency
departments either funded privately or governmentally in order to cope with the
immense number of patients. Recently, it has been observed that the load on
health care units and departments have shown a positive spike due to pandemic
of Covid-19. This research would be focusing on to introduce number of
emergency departments across the country in order to cater the patients and to
address them timely.
Introduction
Emergency
Departments are the basic need of a country. In Health Sector, ED’s play a
vital role in dealing with the threatening emergencies of the patients across
the country. Emergency Departments allows the surety of addressing each patient
and to cure them in time. It is an observable fact that the increase in number
of patients due to pandemic has unveiled our incompatibility with any
disastrous situation like Covid-19. The main aim of this research is to
highlight the importance of emergency departments and to propose a smart model
just like Australia in order to lessen the rampant rate of patients in the
hospitals. The patients must be divided into categories based on severity so
that every patient get checked in time. There must be some walk-in Emergency
Departments where less severe patients can be treated more rapidly. These walk-in
emergency departments help loosen the stress level on the hospital and the
staff. Emergency Departments need to be encouraged in order to cater a huge number
of patients on timely basis. The scope of this research is to propose building
up emergency departments same as Australian Government in order to cater
patients timely and on emergency basis. Basic investment cost and hurdles along
with benefits will be mentioned under the scope of this research. Applications
should be launched, and proper guidance should be provided online in order to cover
a huge number of patients globally.
Literature
Review
Emergency
Departments play a vital role in the overall structure of Health Structure of
any country. The current situation of the pandemic gave a wake-up call to the
Health Institutes and Health Facilities of a world. There is a need to
establish Emergency Departments in order to handle the situational pressure on
the Health Care Departments. Doctors and other staff of the Hospital
experienced a great stress under the Pandemic. The number of patients and beds
became overcrowded which leads to chaotic condition due to Covid-19. Emergency
Departments with a minimum number of 10 beds should be established in sub-urban
areas in order to lessen the stress on the Hospitals. Online help and
prescriptions should be provided to help the patients electronically. Cyber
connections can help the spread of awareness and precautions as to fight the
virus and to eat healthy in order to gain immunity against virus. Guidance and
isolation in order to cure corona patients is to be made available through
television transmission and other customer friendly applications. Social sites
such as Facebook and Twitter should help stimulating the trend of taking
precautionary measures as to prevent the spread of this virus.
Australian
Model of Emergency Departments:
Model
of Emergency Departments in Australia includes medical led triage, medical led
triage and nursing assessment team, rapid assessment team (RAT) and dedicated
assessment areas.
The
Medical Led Triage Includes:
·
Replacing the triage nurse with a senior
doctor.
·
The Triage is to be situated in the
waiting room or the reception area or the triage area of an Emergency
Department.
Medical
Led Triage and Nursing Assessment Team:
·
The triage includes senior emergency
Physician with adequate experience and expertise.
·
The senior doctor works in collaboration
with the triage nurses or the Clinical Initiatives Nurses (CIN).
·
The Triage staff works in collaboration
with the ambulance assessment area in order to investigate on timely basis.
Rapid
Assessment Team (RAT):
The
Rapid Assessment team consists of medical and nursing team members along with
ancillary team members.
This
team assesses the patients on the triage scale. The team members list is as
following:
·
Doctor
·
Nursing Staff (1 or 2 in number)
·
Administrative Staff and Reception
·
Clinical Assistant
·
Scribe
This
team may work in a mobile manner or can offer its services to a certain
geographical area (dedicated area). The working hours of the team should be
24/7 so that its services are available round the clock.
Dedicated
Assessment Areas:
The
area which can be utilized by the Emergency Department is called as dedicated
assessment area, the area includes ambulance point and other staff members of
triage refer the walk-in patients to this area. This area can serve to deal
with patients with greater ease and accessibility.
Hurdles
in the Establishment of Emergency Departments:
·
This formulation of the triage can suffer
the lack of internal inflexibility which can lead to incompatibility to the
changing environment.
·
The use of space and sectioning it can
lead to closing off the space when not in use. More reconfiguration is required
because of rapid changes in the sections of a certain space.
Information
and Communications Technology (ICT) in Emergency Department
Information
Technology is evolving rapidly, and it is necessary to utilize information
technology fully in order to facilitate patients and to take their care. The
services offered by the ICT Department mainly consists of following
infrastructure:
·
Clinical Infrastructure (Devices and
Applications)
·
Communications
·
Administrative Areas
·
Facilities Management and Security
·
Patients, Relatives and Caretakers
Methodology
The
methodology of the research is to propose a design for establishment of
Emergency Departments on different geographical locations to lessen the stress
on hospitals. Under this research it is mandatory to propose a design and
implement the concepts to the real structures for the rapid construction and
strategy planning of the Emergency Departments. The pros and cons of the
Emergency Departments had been shared earlier in the text.
To
begin with the methodology, we must be familiar with the land to man ratio of
an area. An Emergency Department which covers a densely populated area can become
overcrowded at any instant therefore stand by locations should be made
available closer to the ED in order to refer the excessive patients to that
area which can be allotted to the mobile team of triage for medical facilities.
This
study would focus on the establishment of multiple Emergency Departments having
a capacity of 5-10 beds in order to treat patients quickly and avoid
overcrowding in the Hospitals. South Australia consists of 3 Major Tertiary
Emergency Departments in order to deal with major influx of the patients.
Establishment
of an Emergency Department:
An
increased rate of patient’s influx causes the system to overcrowd. Building an
efficient system for quick treatment of patients and home treatment can reduce
the overcrowding in hospitals. While establishing an emergency department,
certain parameters are to be considered which are enlisted below:
Wayfinding:
Providing
clear entrance and clear signage with good lines of sight for efficient dealing
with patients is to be considered as an important aspect while configuring an
emergency department.
Waiting
Area:
Patients
are to be assessed properly in the waiting area in order to be forwarded to the
treatment beds. Acute ailments should be checked by the staff present in that
area. Proper staff should be provided in order to make the proper fast and
effective. Providing a seating facility in the waiting area can reduce the
hassle and patients can be assessed with greater ease. For an example, i.e.
Henderson Hospital in Henderson where improved seating design is adopted to
prevent the patients from long waiting lines.
Improved
Room Design:
With
efficient use of separators and partitions, same old room can accommodate a
greater number of patients in emergency conditions.
Improved
Staff Scaling:
Emergency
Departments can face the problem of overcrowding any time. That is why there
should be proper scheduling of the staff in order to meet any crucial
situation. Staff can be assigned in an incremental manner depending on the
number of patients and their influx ratio.
Improved
Adaptability:
The
Emergency Department and its rooms should have adequate number of rolling
partitions and wheeled furniture in order to make quick changes as per the
arrival rate of the patients.
Examples
of Emergency Departments that are Functional in Different Parts of the World:
As
an example, let’s discuss the departments functional in England. The
departments in England are divided into three main categories:
·
Type 1 Department
·
Type 2 Department
·
Type 3 Department
Type
1 Department:
Major
Department led by the consultant round the clock with full resuscitation
facilities.
Type
2 Department:
Type
2 Department does not have all the specialties. It is only based on single
specialty service (dentistry, ophthalmology).
Type
3 Department:
This
department deals with the walk-in patients that treat minor injuries and
illness.
Discussion
The
World is facing huge stress on its emergency departments due to Pandemic
conditions. The Emergency Departments are overwhelmed, and the health care
workers are exhausted due to increase in patient’s rate. Currently, commonwealth
is struggling to control the situation by increasing the number of beds in the
Emergency Department. Even the increase in staff members in the emergency
departments is done but no significant impact has been observed due to huge number
of patients. The proposed model for the efficient working for emergency
departments is to adopt a triage strategy where different patients are treated
differently depending on the fragility and acuteness of every patient. Implementation
of the walk in Emergency Departments named as “fast track” or “red door” in
order to check patients immediately. The Emergency Departments are supervised by
ED Consultants, Resident Medical Officers and Registrars. In order to release
the stress from hospitals and other staff members of hospital, ED’s are to be
encouraged so that patients do not come directly to the hospital but are
referred after confirmation from the ED, either to admit or not to admit in the
hospital depending on the condition of the patient. In Australia, there are
three major tertiary emergency departments which share the load of the health
care units. Establishment of private Emergency Departments put no stress on the
Health Department.
The
departments in England are divided into three main categories:
·
Type 1 Department (Major Department led by
the consultant round the clock with full resuscitation facilities).
·
Type 2 Department (It is only based on
single specialty service (dentistry, ophthalmology).
·
Type 3 Department (This department deals
with the walk-in patients that treat minor injuries and illness).
On
the other hand, Australia have multiple Emergency Departments:
·
Two in the North (Prospect and Munno Para)
·
Two in the East (Glenside and Magill)
·
Two in the West (West Beach and Large Bay)
·
Two in the South (Happy Valley and Morphet
Vale)
These
ED’s help in reducing the stress and overcrowding of hospitals in Australia.
Two countries are discussed and their mode of operation for the establishment
and working of Emergency Departments is shared in this section of the report.
It is an understandable fact that if Emergency Departments are established
globally then the stress on the Hospitals and the Doctors can be reduced and each
patient can be checked properly and with great ease. Another domain of Mobile
Emergency Departments can become useful in such areas where medical facilities
are scare and rare. The basic facilitation provided by the Emergency
Departments and their referral of patients to different hospitals provided the
basics to organize patients in a much uniform manner where patients can be
organized depending on their condition. The emergency department works as a
bridge and screening unit between hospital and the patients. ED’s with beds and
partitions help in catering and examining a huge number of patients in less
time with greater accessibility to the general public. Major contributions of
the Emergency Departments include speedy checkup points and walk-in checking
which can reduce the overcrowding in hospitals. The aim of research is to introduce
sub-urban Emergency Departments in order to cater a huge number of patients and
prevent the overcrowding of the Health Care Units.
Recommendations
and Conclusions
The
increasing demand in the number of patients has resulted in overcrowding of the
Health Care Units. Emergency Departments are struggling in order to cope up with
the pressure due to Pandemic on the Hospitals and the Staff. ED’s are to be
made more compatible and should meet the modern needs in order to facilitate
patients. Introduction of mobile
applications and online sessions in order to provide the patients adequate
information is the need of time where patients suffering from Covid-19 are to
be properly addressed and guided during home isolation with the help of
internet and other social media applications. The research concluded that
Emergency Departments are of great help in reducing the overall pressure from
the Hospital and the Staff Members. The Emergency Department modelling in
different countries is observed under the scope of this research. The use of
walk-in emergency department and its influence in catering huge number of
patients in less time is also considered under the scope of this research. The
recommendations are to establish sub-urban Emergency Departments in order to
make the medical facilitation and the medical services available to a larger
group of people in a country. Emergency Departments allow the speedy checkup
and referral of patients to different hospitals depending upon the condition of
the patient.
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