Signature Assignment Paper: Culminating Argument
The culminating argument paper is a restructuring of the first two papers with the addition of an abstract, introduction, and conclusion.
- This paper should include a newly composed introductory section and a new final conclusion section that presents your discussion of (and argument for) the solution. Your argument, or rationale, for the solution that you propose is the focus of this paper.
Your paper must:
- Be 15–20 pages in length
- Title page (1 page)
- Introduction (1–2 pages)
- Reworked informative papers (10–15 pages)
- Conclusion (1–2 pages)
- References (1–2 pages)
- Reference 12–15 scholarly, peer-reviewed resources (compiled by combining all of the references from your Perspective of Inquiry papers and any additional resources you use in this final paper.)
- Follow all APA Style guidelines.
- Is over the two papers I’m uploading that you make into one big paper of the four perspectives of the topic of patient satisfaction in the ED.Running head: SCIENTIFIC AND ANALYTICAL INQUIRY 1
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Order Paper NowSCIENTIFIC AND ANALYTICAL INQUIRY 5
Scientific and Analytical Inquiry
Student’s Name
Institutional Affiliation
Scientific and Analytical Inquiry
Declined Patient Satisfaction Scores at Emergency Department
The issue of declining patient satisfaction scores in the hospital emergency department (ED) has undermined patient experience requiring urgent and immediate attention emergence care services. Many patients take a long time from arrival to admission to discharge, thereby forcing them not to make referrals to the hospital. For instance, suppose the hospital needs to increase patient satisfaction scores from the 10th percentile to the 60th percentile and increase the patient volume by 10% from the mean of 7,000 patients per quarter to 8,000 patients per quarter. In that case, it must adopt a computerized clearance and admission system in the emergency room to ensure the work’s fast flow.
Patients’ declined satisfaction scores from the emergency department lead to damage to the hospital image and reputation in general. These declining scores imply increased rates of patients leaving without being treated who attribute the condition to poor emergency care services delivery (Vashi, Sheikhi, Nshton, Ellman, Rajagopal, & Asch, 2018). The main causes of patient dissatisfaction are length waits before getting admitted, and patients walking without being treated (Unwin, Nurs, Kinsman, Rigby, & Nurs, 2016). The emergency department’s policies determine the productivity of nurses in terms of clearing patients to receive emergency services. Many patients decide to leave to look for care services in other hospitals if their current healthcare facility cannot meet their care needs and demands. These incidences are the ones that significantly contribute to decreased patient satisfaction.
The improvement and enhancement of the ED operational efficiency facilitate the hospital to accommodate increased volume while enhancing the quality of care and satisfaction of the ED patients who have minimal additional resources, space, or staffing. In the United States, between 1995 to 2009, the yearly ED visits had increased from 96.5 million to 136.1 million (Sayah, Rogers, Devarajan, Kingsley-Rocker, & Lobon, 2014). This improvement was an increment of 41%, meaning the country’s healthcare system was supposed to have adequate healthcare facilities with enough ED resources to accommodate increased patient visits. Fortunately, the U.S. has witnessed decreasing lengthy ED waits, leaving without being treated, and increased quality care outcomes and patient satisfaction scores (Sayah et al., 2014). According to Sayah et al., (2014), in 2010, only 31% of American Emergency Departments had attained the required triage targets for their patients, and the other 48% healthcare facilities hospitalized their patients within 6 hours.
The impact of decreased patient satisfaction scores implies reduced revenue generation from the emergency department (ED). ED is the leading source and center for revenue collection in any hospital, which supports other departments’ operations. If patients leave without being treated, it means they do not make any payment to the ED; thus, revenue continues decreasing such that the hospital cannot meet its financial needs to operate. So, the impacts of reduced satisfaction scores directly affect the hospital’s ED and finance department in general.
Within the emergency department, various operational issues are leading to challenges such as IT system leaking patient charts and leaving them unprocessed and, therefore, payment left unaccounted, and patients leaving without treatment (LWOT). From an analytical point of view, the loss of documents and charts represent revenue loss and increases incidences of non-compliance. For instance, the assumed analysis below explains how ED can experience revenue loss:
Annual patient visits are 100,000. Assuming that the lengthy waits lower the visits to 85,000 due to patients leaving without being treated (LWBT) and that professional fee reimbursement is $120 per patient visit, the impact of LWBT will be an annual loss of $1.8 million in professional-fee revenue due to low patient flow. If the ED has a yearly LWBT rate of 3%, it will incur a revenue loss of $375,000 in fee revenue.
The primary issues linked to decreasing satisfaction scores involve an unmet expectation of patients needing emergency care services and damage to reputation. The given emergence services should be patient-centered to ensure that the satisfaction scores remain high. The damage to the hospital’s reputation is one of the core areas that need greater attention. Also, the significance of meeting patient care needs may positively impact the reputation of nurses working at the ED. For every 100 patient visits, 50 patients leave before seeing the care provider. Assuming that each patient visit contributes $250, it means when 50 leave the ED, the hospital loses a revenue of $12,500.
Valid patient satisfaction scores motivated the ED to improve the delivery of quality care. If the scores decline, ED, physicians, and entire hospital are negatively affected. For instance, declining scores demotivates physicians or clinicians and affect their job satisfaction because the healthcare outcomes are discouraging and not motivating. In a study by Bachman (2016), 78% of nurses said patient satisfaction scores adversely impacted their work satisfaction in a negative way, and 28% said that the scores make them think of quitting. The manual system’s use to enter patient data, store, and retrieve is the major leading cause of slow patient workflow. Suppose nurses working at ED fail to meet patients’ expectations due to this manual system used to enter, store, and retrieve data. In that case, the outcome is overcrowding, lengthy waits, and leaving without being treated (Vashi et al., 2018). This manual system cause inconveniences that translate to declining patient satisfaction scores.
However, the improvement of emergency care delivery will involve installing a computerized system, Emergency Department System Information (EDIS), that is associated with some economic impact. EDIS is costly and will require the hospital to invest in achieving the necessary change in ED. Once installed, the ED will increase the revenue generation since more patients will get cleared within the shortest time, indicating that many patients will pay more to get emergency services. The ED’s manual system is the main reason behind patients’ complaints about the dissatisfaction with emergency care services offered, which are associated with patients’ experience of long waits, overcrowding, and even leave without being attended (Emergency Care Report, 2020).
According to a study by Newgard, Zive, Jui, Weathers, & Daya (2012), the manual data processing and record abstraction in the ED cannot enhance efficiency in the workflow. Only ED using Electronic Health Records has attained increased effectiveness and efficiency in delivering emergency services that satisfy the needs of patients. The satisfaction scores continue to decline because the manual data processing that involves chart matching, data retrieval, and data entry by a nurse leads to medication errors. Nurses are aware of such declined scores because patients complain about an unclear prescription for medicine, which does not have clear labels. If the ED entirely implements the Electronic Health Record system, the emergency room will not experience overcrowding, and all patients will not leave without being treated.
The hospital continues to lose the revenue collected from ED because when more patients leave without being treated, it means they do not pay. Nurses working at the ED can witness patients’ complaints concerning the hospital’s poor systems that cannot ensure easy tracking of patients’ clinical data and information during admission and discharge. The slow search and retrieval lead to overcrowding since the processing takes long with the manual system. For instance, a nurse can take more than 10 minutes tracking and retrieving a single patient data from the manual data system and even if the data is retrieved, it has high chances of containing errors. These errors may mislead a nurse performing surgery because some nurses do not use explicit language that is clear to read and understand. With EDIS, the system can retrieve data for more than ten patients within 10 minutes, thereby increasing smooth and fast workflow (Newgard, Zive, Jui, Weathers, & Daya. 2012). This data does not contain any error unless it was entered wrongly during storage.
Conclusively, declining patient satisfaction scores within the ED results from the use of the manual system for entering, storing, and retrieving patient clinical data. The increased rate of patients leaving without being treated and overcrowding of the emergency room harms the ED’s revenue. An automated system is needed to facilitate easy storage, tracking, and retrieval of data to enhance smooth work-flow at ED, thereby increasing patient satisfaction scores. This automated system will also ensure an increase in revenue generation since more people visiting the ED will get admitted without any delay. In general, increased patient satisfaction scores rely on the used ED system that should be computerized rather than manual data processing.
References
Bachman, J. W. (2016). The problem with patient satisfaction scores. Family practice management, 23(1), 23-27.
Emergency Care Report (2020). Emergency department patients waiting care. Retrieved from https://www.health.nsw.gov.au/policies/manuals/Documents/pmm-6.pdf
Newgard, C. D., Zive, D., Jui, J., Weathers, C., & Daya, M. (2012). Electronic versus manual data processing: evaluating the use of electronic health records in out‐of‐hospital clinical research. Academic Emergency Medicine, 19(2), 217-227.
Sayah, A., Rogers, L., Devarajan, K., Kingsley-Rocker, L., & Lobon, L. F. (2014). Minimizing ED waiting times and improving patient flow and experience of care. Emergency medicine international, 2014.
Unwin M., Nurs, G., Kinsman, L, Rigby, S., Nurs, G. (2016). Why are we waiting? Patients’ perspectives for accessing emergency department services with non-urgent complaints. International emergency nursing 29.
Vashi, A., Sheikhi, F., Nshton, L., Ellman, J., Rajagopal, P., Asch, S. (2018). Applying lean principles to reduce wait times in the VA emergency department. Military medicine 184(1).
