The Emergency Department: Rising wait times, costs, and possible remedies

Emergency Departments (EDs) and Emergency Rooms (ERs) are designed to manage trauma, respond to disasters, and serve as the initial care for those with serious illnesses. However, because of many factors, the ED has become the doorway to the hospital and a “catch-all net” for patients including those with non-urgent needs. This increase in the population in the ED has lead to an increase in wait times for patients. It has been well documented that there has been a constant and consistent rise in the number of patients that frequent the ED (National Center for Health Statistics, 2002); the wait time for patients in the ED has increased (Pitts, Niska, Xu, & Burt, 2008); and the cost of the treatment in the ER has risen (Everett Clinic, 2008). Because the ED was designed to treat patients who need quick diagnoses and may be in potential life-threatening circumstances, management of time can be the ultimate enemy. If a system was implemented to decrease wait times in the ED, decrease the use of ED resources, and decrease costs endured by patients seeking care, better outcomes for patients and patient satisfaction could be achieved. The goal of this research was to explore potential changes and/or alternatives to relieve the burden endured by the ED. In order to explore these options, data was collected by conducting one-on-one interviews with seven physicians closely tied to a Level 1 ED (Emergency Room physicians, Trauma Surgeons and Primary Care physicians). A qualitative analysis was performed on the responses of one-on-one interviews with the aforementioned physicians. The interviews were standardized, open-ended questions that probe what makes an effective ED, possible solutions to improving patient care in the ED, potential remedies for the mounting problems that plague the ED, and the feasibility of bringing Primary Care Physicians to the ED to decrease the wait times experienced by the patient. From the responses, it is clear that there needs to be more research in this area, several areas need to be addressed, and a variety of solutions could be implemented. The most viable option seems to be making the ED its own entity (similar to the clinic or hospital) that includes urgent clinics as a part of the system, in which triage and better staffing would be the most integral part of its success.^

Women in the factory: an administrative adventure, 1893 to 1921

by Adelaide Mary Anderson ; foreword by the Right Hon. the Viscount Cave.

The brown-tail moth, Euproctis chrysorrhcea (L.). A report on the life history and habits of the imported brown-tail moth, together with a description of the remedies best suited for destroying it. By Charles H. Fernald ... and Archie H. Kirkland ... Pub. under the direction of the State board of agriculture by authority of the legislature.

1903

The brown-tail moth, Euproctis chrysorrhcea (L.). A report on the life history and habits of the imported brown-tail moth, together with a description of the remedies best suited for destroying it. By Charles H. Fernald ... and Archie H. Kirkland ... Pub. under the direction of the State board of agriculture by authority of the legislature.

1903

Empire Ottoman: division administrative

dressée d'après le Salnamé 1899/1317 par R. Huber.

Translations of the Ottoman constitutional laws: the Wilayet Administrative Law, the Municipal Law and various other laws

Ottoman constitutional law of the 7th Dhil Hujjah, 1293 AH [December 24, 1876 AD] as amended. -- Regulations of the Chamber of deputies. -- Regulations of the Senate. -- Provisional law of administration of wilayets of the 13th March, 1329 AH [March 26, 1913 AD] as amended. -- Municipal law of the 27th Ramadhan, 1294 AH [October 5, 1877 AD] as amended. -- Law regulating chambers of commerce and industry, dated the 31st May, 1326 AH [June 13, 1910 AD]. -- Provisional law of expropriation on behalf of municipalities dated the 21st Kanun Thani, 1329 AH [February 3, 1914 AD]. -- Regulations of expropriation for public purposes, dated the 24th Tashrin Thani, 1295 AH [December 6, 1879 AD] as amended. -- The Press law of the 16th Tamuz, 1325 AH [July 29, 1910 AD] as amended.