State of the Emergency Rooms

Emergency Rooms--as perceived from the patients point of view--are always understaffed and poorly managed. They tend to display chaotic behavior and makes one ponder as to whether anybody within the top ranks of health-care industry is doing their job. Speaking with first hand experience, which unfortunately I have gained in past few years visiting multiple ERs, most of the ERs seem to depict dilapidated affairs. Partially the reason being that any new patient is not taken in based on the time the patient came in, but rather the severity of the condition of the patient.

Walking into ER itself brings shivers to my spine as it has a huge "uncertainty factor" attached to it. There is no guarantee when the doctor is going to see you after you are triaged. The wait could be anywhere from couple hours to a whole day. Ideal situation would be that there are no other patients in the waiting area who have worse condition than yours and that the hospital has a bed for you. 99.99% of the times you won't be lucky to get both of them in your favor. Furthermore, as the wait time increases, so does the influx of patients as they keep coming in. So pray that either nobody else come in after you are triaged with worse condition or you have the worse condition.

Apart from the inherent nature of the ER, there are things that definitely can be managed effectively and can help expedite the process. McKinsey has a very good article on how to fix the overcrowding problem in ER. They have enumerated lot of reasons causing the delay in ER room, but the one that stands out, which I have experienced almost everytime I have been to the ER, is the time taken to discharge the patient from ER. A bed in the ER is the key resource and majority of the time the backlog is caused by unavailability of the beds. On an average, it takes almost 20-30 minutes to discharge a patient irrespective of the hospital/chain. In other words, the patient is ready to leave and there is no other reason for him to stay except to sign some papers. Imagine a patient under sever chronic pain waiting in the sitting area for a bed to get freed and is not able to sit on a chair. Yours truley happens to be one of those patients. Just by reducing the time of discharge, ER can increase the number of patients it can serve in given amount of time, not mentioning how happy the patients would be by the reduced waiting times.

Besides the process management, customer service is the other aspect that needs proper addressing. As in case of any kind of business, the customer is the king. In case of ER, the patients who show up happen to be in the worst possible state they can possibly be in. "Handle with Love and Care" must be the modus-operandi. Altruistic nature should not be only reason the patient gets loving care at the hospital, but it should be what the nurses and staff members along with the doctors should always adhere to as a principle. I can easily recall from my past visits that the times when the staff was gentle and kind, I ended up remembering that visit as a pleasant one, even though the pain might have been worst. Altruism is not a natural trait in human being, but atleast it should be one of the core values that the culture within the hospitals should be build upon.