Strategies To Improve The Work In Emergency Department

From the research I completed, it was noted that 16 million visits to an emergency department were made in Canada in 2010-2011, and out of these visits 48% were triaged as low-acuity. The amount of low acuity visits is of similar proportion in regards to the pediatric population as well. The increased proportion of low-acuity visits may be due to a lack of appropriate resources or parental over-estimation of acuity severity. This consequently leads to overcrowding in emergency departments, which negatively impacts quality of care for both high and low-acuity patients, leads to lower patient satisfaction and longer wait times, which we know can be detrimental especially for a pediatric client. Therefore, it is crucial to know when it is appropriate to go to the ER and the circumstances when visiting a health clinic would be more suitable option.

Further education to patients and parental education for pediatric clients would enhance knowledge required to make this informed decision, which would help in managing the high low-acuity rate noted in emergency departments. I believe this would resolve the overcrowding concern in many hospitals, leading to shorter hospital wait times, which would enhance the health outcomes for adult and pediatric clients in high-acuity circumstances. In regards to the triage process, I strongly believe that health care providers working in the emergency unit should be required to have a baseline competency level regarding pediatric care. Realistically, I do not believe this is always possible and often times emergency departments are short staffed already. However, I believe this issue can begin to be resolved by establishing a universal guideline with recommendations that is agreed upon and utilized by all health care providers, including having coordinators for pediatric emergency care, having age appropriate equipment readily available in the ER and protocols specifically established for children.

Health care providers also have varying opinions regarding the triage protocol for pediatric patients, so it is crucial for universal protocols to be developed based on current evidence-based research by health care providers of pediatric speciality. The universal protocols need to be firmly implemented in emergency departments, which would enhance consistency in the triage process and decrease conflict experienced among health care providers.

I believe that pediatric specific emergency departments are not being implemented in many hospitals across Canada due to barriers such as lack of funding and resources. I was interested to see if there were pilot projects being carried out to assess alternative ways this could be implemented in a financially feasible manner. I found an article that discussed a community hospital in Maryland, USA where a pediatric inpatient unit was combined with the pediatric emergency department and had one staff in charge of both units. This combination was not only financially beneficial but also increased staffing sustainability, as the pediatric nurses enjoyed working specifically with pediatric patients. The combined pediatric resources also only had resources and equipment specifically for pediatric clients as well, which enhanced client satisfaction and led to positive client health outcomes.

I believe that the implementation of these few suggested strategies would act as a step in the right direction for enhancing pediatric care.