Emergency Room Use for Non-Emergent Treatment

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TABLE OF CONTENTS

CHAPTER 2: LITERATURE REVIEW1

Emergency Room Health Care in the Twentieth Century3

Emergency Department Visits7

Populations Treated in the Emergency Room9

Characteristics of patients who visit Emergency Departments10

Nursing Staffing / Patient Ratio20

Causes of Delays in ED Throughput22

Overcrowding22

Disparities in ED utilization26

Uninsured27

Usual/Regular Source of Care and ER Usage29

REFERENCES31

CHAPTER 2: LITERATURE REVIEW

According to Babb (2009) for many years, throughout the United States the health care quality delivery and satisfaction of patients in hospital emergency rooms have been noteworthy discussion topics. According to Andrews (2007), these topics are recognized more often in the early part of the 21st century than in the past. According to patients treated in United States hospital emergency rooms, as emergency room patients there are numerous factors that influence their level of satisfaction. According to Bhoi (2010) these factors includes courtesy levels of staff's, emergency waiting rooms cleanliness, privacy of patient, wait times appropriateness, and management of pain during the emergency room visit.

According to Branswell (2003) attributable factors are identified as an inappropriate attitudes and discussions about patients and their families, and this leads to patients' dissatisfaction in receiving health care treatment in hospital emergency rooms. According to Boyatzis (1998) a nation-wide survey conducted in 2002 in the United States, reported over 90% of urban hospital emergency rooms are overcrowded. According to this same survey, overcrowding has contributed to several other problems. According to Bhoi (2010) ambulance refusals, extended patient waiting times, and extended hours of pain for an overwhelming number of patients are a result of overcrowding. Situations, like overcrowding have created a hurry up and wait environment and patients believe they are rushed in an unwelcoming environment. According to Center for Disease Control, (2009) the delivery of poor outcomes in staff efficiency influences overcrowding and leads to patient dissatisfaction. According to De Santes (2004) the impact of overcrowding on emergency rooms, retrospectively affects the complete operation of emergency rooms. According to Fisher (2009) the ability of emergency rooms to respond to community disasters becomes hindered by limited space, time and resources, thus affecting patient satisfaction. According to Ferrari (2006) a lack of emergency room resources diminishes the efficiency of medical staff and hospitals cannot continue to meet the growing demands of hospital emergency rooms. According to Edwardson (2007) in addition to overcrowding, a lack of resources hinders medical staff's ability to perform at quality levels, which also contributes to staff's dissatisfaction with their jobs. Unhappy staff inadvertently affects patients' level of satisfaction with their emergency room experience. Ferrari (2006) discussed the impact of unhappy staff on patients' level of satisfaction with their emergency room experience. According to Franc-Law (2010) a growing number of health care leaders do not support a failing health care infrastructure in hospital emergency rooms.

According to Hedges (2002) the lack of resources, continual overcrowding and medical staff's lack of effectiveness are increasing whereas, patient satisfaction and meeting patient health care needs are decreasing. Many medical reasons exist for, which patients present themselves to hospital emergency ...