Reducing misuse of Emergency Departments!

Specialties Emergency

Published

After reading much of the posts about ED Nursing, my first suggestion would be for people to stop inserting objects where they do not belong!.On a more serious note, i just read an article in the paper about a study completed which showed that 41% of parents undermedicate their children for fevers. the study examined Emergency room visits, and it determined that those visits could have been avoided had the children been dosed appropriately. What are your suggestions to reduce unecessary visits to the ER?

I just wanted to say I think it's wierd that hospitals in the States serve the pts food while in the ER. Even with a doctors approval. Here they get sent to the cafeteria. Pump and all. Unles...they're being admitted and its going on day number two.

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:angryfire ONE REASON WHY THE ER VISITS ARE SO PREVALENT IS THE WAY THE PRIMARY PHYSICAN RUN THE PLACE. THE MD I GO TO IS IN PARTNERSHIP WITH UMPTEEN OTHER MDS THE BOTTOM OF THE TOTEM POLE HAS TO SEE PTS IN ER ---THE PRIMARY WILL NOT PRESCRIBE ANYTHING NOR WILL THEY WORK IN A PATIENT NOT ON APPT BOOK BUT THEIR NURSE TELLS YOU TO GO TO ER BACTRIM FOR A UTI WOULD NOT BE OUT OF LINE W/A FU APPT WHEN THEY COULD MANAGE IT

IT WOULD NOT DO ANY GOOOD TO CHG MDS BECAUSE THEY PROBABLY ALL DO THE SAME THING AND THE HMO WILL ONLY ALLOW A CHG ONCE A YEAR UNLESS YOU CAN PROBE INCOMPTENCE BY THE WAY THEY TOOK A SPEC FOR C/S AND THEN WROTE OUT SCRIPT THEY MUST HAVE A SECRET LAB THAT WILL GIVE THEM RESULTS IN THE 4 HOURS I SPENT IN A COLD COLD COLD ER IN ONE OF THEM FANCY GOWNS GIVE YOU A LITTLE EMPATHY LOVE U ALL

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Specializes in ER,ICU,L+D,OR.

we all look forward to Universal Health Care to help this problem

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Specializes in ER.
During the flu outbreak in December, our Infection Control Nurse put a sign on the ER door for folks who thought they had the flu not to enter! Nice gesture, but I told her to move it to the visitors entrance.

too funny!!!!!

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Specializes in OR, ER, TRAVEL, SURGICARE, WOMENS HOSP.

Boy! Isn't this posting the 64,000 dollar question in the ER. Who knows what this new healthcare leader Mr. Daschle will have in store for us. I too am very tired of the abuse of use of the ER. When gas prices where high it was a good excuse not to drive to a urgent care facility for they had no money for gas. I just wonder how we can break the chain of people who think they are entitled to receive free heathcare! When will people accept responsibility for their own?? I think reasons to go to the ER should be posted on a large billboard for all to see. Why do people not have pride anylonger. I have had pt's say to me " I have not money, no insurance, no doctor and no gas. Can I get my prescriptions filled until I can make it to the free clinic? I just want to say get a job, get insurance and get a family MD!!

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Specializes in OR, ER, TRAVEL, SURGICARE, WOMENS HOSP.

OK! What to do about these issues? We need to all band together and present the issues to our representatives so he/she can pass on the the new head of Healthcare chosen by president elect Obama, Mr. Thom Daschle. He needs to visit the Emergency Room for about a week to see how it realy is with healthcare. No one pays... No one has insurance and no one has a family MD for they probably owe them money and he will not see them again. It seems there is a continuance of welfare from one generation to the next. I will say it again... how do we break the chain and instill pride in the people and not expect free medical care for them and their children?

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Specializes in ER,ICU,L+D,OR.

There are a lot of issues in this subject.

I feel Obama has made some good choices to deal with the situation.

Daschle while not my favorite, very capable and wise. This is a very rich country. Health care should be an affordable priviledge to everyone. Easy to set up and easy to fund, actually.

I think the works program is an excellent step. Myself.

I think ending the war would be a right step also. A war we helped start what was it 30 years ago now.

But if private MDs made a living seeing indigents who are now on nothing. Then they would see them in office. and cut down ER visits.

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Specializes in EMERGENCY.

Why don't we build huge minor injury unit and huge primary care clinic infront of every emergency depatments. The role of the triage nurse will be to divert patients into appropriate place. Only real emergencies will be allowed to enter ED. Simple solution isnt it?

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Specializes in ER,ICU,L+D,OR.
Why don't we build huge minor injury unit and huge primary care clinic infront of every emergency depatments. The role of the triage nurse will be to divert patients into appropriate place. Only real emergencies will be allowed to enter ED. Simple solution isnt it?

Has nothing to do with the situation. It all boils down to strictly money. Just the war strictly boils down to nothing but oil. Get these people health coverage so the can be seen by MDs in private practice. Then they will not come as often th the ER

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Specializes in Retired OR nurse/Tissue bank technician.
Has nothing to do with the situation. It all boils down to strictly money. Just the war strictly boils down to nothing but oil. Get these people health coverage so the can be seen by MDs in private practice. Then they will not come as often th the ER

That's no guarantee of proper ER use. We've got universal health coverage up here. I've been in the ER a few times and the things people have come in for are as bad as the ones you describe.

I was in one time for what we feared was a Steven-Johnson syndrome reaction to a drug. It was a busy day with several serious MVAs and codes/near codes, so I had to wait for a while to be seen. I was sitting near the triage desk and could hear some of what the people were saying as they checked in or as they swapped 'why are you here?' stories with other patients.

There were people there complaining of nausea and vomiting making purchases from the snack machine, people with a sore foot that were walking around and sometimes taking a few running steps without a limp or any sign of pain, 'horribly sick' babies that were walking around, laughing, pink and sucking on a bottle of juice.

Then there was the woman across from me in the waiting area who had already been to her family doctor that morning with a small lump in her neck. The doctor had told her it was less than 0.5cm across (it takes 2.5 centimetres to make an inch, so we're talking about 3/16") and was almost certainly a lymph node fighting a virus. She was to keep an eye on it and if it didn't go away in a few days, to come back into the office and he would reexamine her and if the node was still there or had gotten larger, would run blood work to ensure it wasn't anything more serious. Sounded to me like a perfectly treatment plan.

She was in the ER, in her own words 'to get a second opinion because it's better to be safe than sorry' . :trout:

A possible partial solution to inappropriate ER visits? More programs like the one I describe below.

My family doctor has tied in to an after-hours clinic through a local hospital. It's open four or five hours every weekday evening, plus four hours on Saturday mornings. Because it's in a hospital, they have access to X-ray, labs, etc that would not be immediatley accessible in most MD offices. A report of the visit, complete with all test results is usually in the GP's office the next morning. Some of the doctors who have tied into the clinic as well as some locum doctors who want to pick up a few extra shifts take turns seeing patients and most of the RNs working the clinic are part-timers from the nursing units who want to pick up a few extra 'easy' hours.

Last year I developed a nasty sore throat to the point that swallowing saliva had me in tears, followed days later by a sinus infection that had me up the better part of the night with the pain. My family doc wasn't able to get me in, so I went into the after hours clinic to be seen both times. I was taken in within minutes and saw a doctor right away. They did a full exam and wrote a prescription and/or else gave me ideas of how to treat the pain/pressure/breathing issues using OTC and home remedies if antibiotics were not the appropriate treatment. Everyone was professional, unhurried and empathetic.

Had I not been able to get into that clinic, I may well have wound up waiting for hours in ER for that sore throat, because the pain was making eating difficult if not nearly impossible, plus I was having some troubles with my vocal cord disorder. Instead I was in and out in less than 20 minutes, knew how to handle things at home and was reassured by the doctors that if I was still having trouble, I could come back the next night and be given more help. The cost to the healthcare system for my visit to the clinic? $40, compared to a couple of hundred if not more for an ER visit.

That won't help the people who call for an ambulance at 2am because they have a hangnail, but it might help divert some of the patients who would come in for things that are borderline as to whether they should be in ER or not, patients wanting a random pregnancy test, as well as parents with kids who come home from work and find a sick kid but can't (or don't want to) take time off of work to take the child to the doctor the next day. My doctor's office advertises the clinic and if someone needs to see a doc but can't get in, they'll be told to access the after hours clinic.

Now that it's been open a year or so it's probably busier than it was last winter when it was just a few months old, but even still, it beats a trip to the ER for less than emergent problems.

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I just wish I could educate the public on the proper use of EMS. I have had so many patients come in the front door that should have come by EMS that it boggles the mind! I always good naturedly admonish them. :chuckle

guilty....Vomited blood, went in by train to my hospital, when asked why i didnt call an ambulance, i was fine to get here my self...they told me what they thought of that plan

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I think educating the public of proper use of the ER needs done. Lots of times it's part of our discharge instructions. There will always be those who have nowhere to go and can't afford insurance though. It can be quite frustrating.....on both sides of the coin.

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