Easing the Chaos in Emergency Departments: Implementation of the ‘Ask Your Nurse’ Teletriage Program

Abstract

Nurses working in the emergency departments of large, metropolitan health care facilities have long experienced overcrowding in waiting and treatment rooms. The problem has only become more pervasive as individuals with non-emergent conditions inappropriately seek health care in the emergency department. It has been hypothesized that potential causes of delayed care include absence of appropriate infrastructure (eg, lack of ED space and acute bed availability), influx of non-emergent patients, and understaffing by qualified emergency nurses. 1. Natal G Emergency department overcrowding: What is the answer?. J Emerg Nurs. 2007; 33: 99-100 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar These delays can be frustrating for patients and personnel, increase health care costs, and decrease potential income for hospitals. The gap between demand and supply can lead to anxiety among clients and potentially result in adverse clinical outcomes. Researchers noted that in 2004 alone, approximately 101,000 patients with conditions classified as non-emergent were treated in 11 hospitals throughout the greater Houston area. 2. Begley C Aggarwal M Burau K Dang H Houston Hospitals Emergency Department Use Study. Gateway to Care. 2006; : 1-46 Google Scholar Overcrowding has resulted in diversion of ambulances from a preferred hospital to a different health care facility on average of 1 every minute. 3. Burt C McCaig L Valverde R Analysis of ambulance transports and diversions among US emergency departments. Ann Emerg Med. 2006; 47: 317-326 Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar Mary Bossier Bearden is Nurse Manager, Ask Your Nurse Program and High-Risk Nursery, Lyndon B. Johnson General Hospital, Houston, Tex. Titiana Brown is Nurse Coordinator, Ask Your Nurse Program, Lyndon B. Johnson General Hospital, Houston, Tex. Kenn M. Kirksey is Director of Nursing Research and Clinical Outcomes, Harris County Hospital District, Houston, Tex. Moranda Dansby is Director, Women and Children Services, Lyndon B. Johnson General Hospital, Houston, Tex. Margo Hilliard is Senior Vice President, Community Health Services, Harris County Hospital District, Houston, Tex.