“ED sees critical capacities”
Emergency Department (ED) crowding is a public health crisis associated with negative patient outcomes including increased mortality and complication rates. Decreased quality in delivery of care is affected by lack of resources to support the increased use of emergency services and is a factor that leads to delays in treatment and untimely interventions. According to the article, Dr. Gordon, an emergency medicine physician and director of the Neighborhood Hospital ED states one of issues within the community is a lack of resources including “adequate medical facilities, especially for low-income individuals or indigents” (“ED sees critical capacities”, The Neighborhood). This problem is widespread throughout the United States and is not limited to the indigent population. Although it is difficult for patients with Medicaid to find providers willing to accept their insurance, the lack of primary care physicians causes limited access to health care for those who do possess private insurance, and patients are often referred to the ED by their primary doctor who may be unable to see them as appointments are usually unavailable for weeks at a time.
With limited access to care, hospital emergency rooms become saturated due to non-urgent visits, inadequate staffing, and hospital bed shortages. When the hospital reaches maximum capacity and can no longer admit patients to appropriate units, the ED is forced to board these patients in the department, which leads to ambulance diversion, increased wait times, and the creation of makeshift treatment areas. The culmination of these factors contribute to delays in transport and time sensitive emergent care, patient elopement where care is not received at all and delayed even further which can lead to worsening health requiring hospital admission, and lower quality of care, which negatively affects patient safety and outcomes (Hoot & Aronsky, 2008).
This article increases public awareness to the problem of crowding in the emergency department and encourages the use of community-based resources for non-urgent medical conditions and the need for education on the appropriate utilization of emergency medical services. “Smoking breaks a thing of the
According to “Tobacco Use” (2013), “Tobacco use is the single most preventable cause of death and disease in the United States” (Why Is Preventing Tobacco Use Important?). This article highlights the advocacy of large companies to reduce tobacco use for the improved health of their employees and to eliminate exposure to unwanted secondhand smoke. Environmental tobacco smoke is just as detrimental to non-smokers as it contains harmful substances that expose those who don’t smoke to the health risks of cigarette smoking and increases their risk of developing a smoking-related illness. Promotion of a smoke-free work environment not only benefits the employees, but also the public whom they serve by reducing exposure to environmental smoke that causes heart disease, lung cancer, respiratory illness, and has other adverse effects to vulnerable populations including pregnant women and children. These companies are increasing community awareness to the detrimental affects of smoking and exposure to secondhand smoke by paving the way to eliminate exposure to environmental smoke and reduce tobacco use in an effort to reduce illness and health care costs related to smoking, and increase productivity of employees and the overall health of their communities. The public benefit to this is that many states are enacting smoke-free laws in the workplaces and public buildings to reduce the number of deaths and disability caused from involuntary exposure to tobacco smoke.
Centers For Disease Control and Prevention. (2013). Health effects of
secondhand smoke. Retrieved from
Hoot, N.R., & Aronsky, D. (2008). Systematic review of emergency department
crowding: Causes, effects, and solutions . Annals of Emergency Medicine,
52(2), 126-136. doi:10.1016/j.annemergmed.2008.03.014
McClelland, M.S., Lazar, D., Sears, V., Wilson, M., Siegel, B., & Pines, J.M.
(2011). The past, present, and future of Urgent Matters: Lessons learned
from a decade of emergency department flow improvement. Academic
Emergency Medicine, 18(12), 1392-1399. doi:10.1111/j.1553-
The Neighborhood Pearson Health Science (Version 1.0) Retrieved from UOPX
NUR408 Course Materials
Tobacco use. (2013). Retrieved from