Wont this just make it worse?!?!

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Specializes in ICU, PACU, Cath Lab.

Ok...as I start out most of my posts on this board...I am not a nurse..yet..I graduate in May, I am an EMT-B, so I have done some work in an ER...no nursing work besides a couple days as a student...not anything like really being a nurse..my disclaimer..so no one feels the need to flame the non-nurse:nuke:

In my town we have to ER's and lately they have been advertising their "Fast Track" departments...you know for the non critical patients..well now since the competition is heating up one of the hospitals is advertising that they will see you in 30 min or less in the hospital fast track...OK..I can only imagine that they are getting completely flogged with non emergent cases...I mean I take my daughter to urgent care...a clinic type, when she has an ear infection and her DR is not working...we wait an hour and a half...I am thinking man I should have taken her to the ER...I would be done by now...but I just cannot do that ER's are for EMERGENCY's. But I think the hospitals are digging themselves a hole here...I mean they complain about non emergent cases coming there...and then they do this!!! I feel bad for the staff cause you know it is not up to them....how would you ER nurses feel if your hospital was doing this...and if your hospital did do this...how did it affect your jobs???

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Specializes in acute medical.

We have fast track here, but only so many beds. Priority is still triaged, and I have to agree that a 30min guarantee is really bad hat...

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Specializes in Emergency Room.

We have a "fast track" area that hasn't really been advertised much. Whenever I'm in triage, you get a lot of people who say "and I heard you have an urgent care." I have to correct them very quickly. The fast track is a separate 6 bed area that is staffed by an MD, RN, and tech. Technically, pts should not be there for more than 2 hrs. We function somewhat as an urgent care, but still do a lot of nonurgent care cases....IV abx, minor sicklers, back pn requiring IV narcs, etc etc. It is an awful area for a nurse because you just run the WHOLE time.

What people don't understand when they come to us "because you have an urgent care" is that we still triage for the whole dept. The fast track area does have monitors, so if there is no more space in the main ED for a CP, we get it (at least until a spot opens up). I guess what I'm saying is that the fast track pts don't get put into a different line; everybody is lined up the same, which causes some frustration.

I think the "30 minute guarantees" are crap. We effectively just put ourselves on the same level as Dominos or Pizza Hut "get done in 30 min or it is FREE!!!" Why not offer a "your choice of narcs" guarantee instead? I realized that healthcare is becoming increasingly competitive, but I think we need to be elevating ourselves, not coming down to the level of pizza delivery.

((((stepping down from soapbox))))

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30 minutes or it's free? Yep - sounds too much like pizza delivery.

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This whole 30 minute thing had to be designed by someone with a business background and not clinical.

We have a small ER here in rural Ohio - 4 beds - however, we flip those beds quite a bit - plus the nurses have to register the patient, answer the phones, process their own orders - you name it.

We have patients that complain that have to wait 15 min to 30 minutes to be brought back to a room. You - know the non-emergent ones that have an "airway" to complain..... - Then if one of these patients walks out before being seen, we have to write up an incident report. Administration gets PO'd at every one that occurs. However, they have no solutions to offer.

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If it's put in writing there is probably a fine print disclaimer that says the time can change according to pt census.

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Yeah disclaimers are good@

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The way it works in my hispital is that the triage nurse screens both the Er patients from the "Fast track" patients so yes the fast track patients are triaged (seen) in 30 minutes but they are not through yet to see the doctor or even in a fast track room for quite sometime depending on how busy things are. Once in fast track they are seen by a PA that works under the ER physician .

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Specializes in ER, Oncology, Travel Nursing.

The hospital system I work for trialed a program called "33 or Free". It was pretty much you were registered, put in a room, and seen by a medical person within 33 minutes. If this did not happen, you would not be chared a doctor or hospital fee. This came out of our "wonderful Marketing department" which does not have anyone medical in the department.

It was trialed at 3 of the hospitals in the system...one of them being the one I worked at. I work in a small town ER and there is only one other hospital in the city over from us...otherwise it is a 40 minute drive to the "bigger city" hospitals.

Anyways...the program was in affect 24/7 no matter what census/accuity was...the only disclaimer was the program was not in effect during a natural or mass disaster. There were only 4 "free" cases that were given away between the 3 hospitals.

The program was suppose to last 1 year...but they cut it early at about 8 months. The program was a flop. The marketing department figured it would see a 10 percent increase in numbers...that never transpired. They only saw a 2 percent increase in numbers!!!!! And that is in general more people are using the ER for routine care.

Programs like these are not as effective anymore because if you have insurance, you are told what doctors and physicians to see...the older people on Medicare go where their doctors tell them which hospital to go too...usually the one they practice at. So that leaves the one who are on Medicaid and no insurance...they can go to any ER at any time and receive care...and we all know how much hospitals love those payment sources!!

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