Essay on Budget and Implementation Plan of a Fast Track ER Unit

The main aim of this economic initiative is to reduce waiting time and overcrowding in the hospitals emergency rooms. According to Hanson et al. (2014), overcrowding is one of the main issues facing hospitals today. Further, Hanson et al. assert that overcrowding in the emergency department can result in preventable medical errors since it may result in increased stress on personnel in this department and hence affect the quality of service. A fast track ER unit will reduce overcrowding in the emergency department since patients with minor emergencies will receive fast and quality treatment without the need to go to the main emergency room. This will benefit a lot of people including patients, nurses, doctors, and administration. Patients will benefits as they will spend less tie on the emergency room and receive quality treatment. Nurses, on the other hand, will find their work much easier as patients will be satisfied and in a better mood since their time will be valued. Similarly, doctors benefit as nurses and improve their efficiency as they will be seeing more patients at a given time. Finally, the administration will benefit as the fast track ER will improve overall patients satisfaction and thus allowing the hospital to have a positive reputation. In short having a fast track ER will reduce the time a patient spends in the emergency room and thus increase the satisfaction of both the patient and the staff (Rodi, Grau, & Orsini, 2006). This paper outlines the implementation plan for the proposed fast track ER initiative.

Budget Plan

The budgeting plan will take into consideration the expected materials and equipment, staffing and capital costs needed to implement the fast track ER initiative. The materials needed in the fast track ER are basic equipment required to deal with minor emergencies. These materials include Pyxis, suture cart, gynecology supplies such as forceps and gauze, and computers and printers which will be used for prescriptions, instructions, label printing, and other entry. The staff will include a full-time physician, two nurses, and a technician. The expected capital costs for the fast track ER initiative has been estimated at $395,000 for the first year, $406,200 for the second year, $407,500 for the third year, $399,600 for the fourth year and $399,200 for the fifth year and this can be seen in the budget plan in the appendix. Since the fast track ER unit will improve quality of service, customer satisfaction and reputation, we expect to obtain sufficient revenues from the initiative. The projected earnings for the initiative are expected to be $500,000 for the first year with a five percentage increase over the next five years. With proper management and leadership, the initiative is bound to be successful and viable for the healthcare setting over the next years.

Implementation Plan

Timeline to Roll Out the Fast Track ER Initiative

Month

Activities Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Engage hospital leadership Identify space Obtain equipment Establish triage process Manage patient expectations Staff education Identify operation hours Determine appropriate staffing Ramp up period To ensure that the initiative is implemented successfully and sustained we will work effectively with relevant stakeholders. One of the ways that this will be done is by openly sharing and discussing all the ideas with the stakeholders before implementation (Newcomer, Hatry, & Wholey, 2015). There will be constant communication, and each stakeholder will be updated on the progress of the initiative. This will make it easier for stakeholders to understand tasks that need their approval. Secondly, the perspectives and constraints of each stakeholder will be taken into consideration and a compromise made so that the imitative will take off. Finally, there will be a framework aimed at capturing unforeseen events so that they may be addressed promptly (Newcomer et al., 2015). Sticking to these three items will ensure that the initiative progresses smoothly and each stakeholder is satisfied.

The rollout will be conducted in an ethical and culturally equitable manner to ensure that the initiative achieves quality and service improvement. The persons involved in rolling out the initiative will adhere to the healthcare organization code of ethics and professional obligations. They will fully disclose any conflicts of interest that may arise in a timely manner. Additionally, they will honor all cultural, ethical, and legal obligations of the community they serve. Lastly, all stakeholders will be provided with honest and accurate information about the initiative which will ensure that everyone is involved in the process. In short, the people involved with the rollout will focus and put into consideration all the rules of law, code of ethics, customs, and norms of the community when implementing the initiative.

To ensure that the desired quality and service improvements of the initiative are still on track during and after implementation there are a number of things that will be taken into consideration. These includes having clearly defined goals, sufficient resource allocation, adequate communication channels, feedback capabilities, executive support, and efficient control mechanisms. However, these factors are not an assurance that we will not experience problems during and after implementation, they only provide guidance since the initiative will be a process of continuous improvement. Nonetheless, we will devote ourselves to overcome the hurdles so as to ensure the initiative becomes successful.

Impacts of the Fast Track ER Initiative on Other Aspects of the Care Setting

The initiative will impact other aspects of the hospital in either positive or negative way. Some of the aspects that are highly likely to be impacted positively include quality of service, patient satisfaction, the reputation of the hospital, and improvement in efficiency. The positive impacts are mainly as a result of a reduction in the length of stay and waiting times for patients with mild conditions. This reduces overcrowding which in turn reduces frustration among medical practitioners and improves the process of care delivery (Hwang, Lipman & Kane, 2015).

On the other hand, the negative impacts include increased workload on the testing department and borrowing of staff hours from another part of the care setting. The workload in the testing department increases because the fast track ER unit will not have its dedicated laboratory but will share the testing department with other sections of the hospital. Thus at certain times the laboratory personnel will have huge workloads hence working for extra hours. Other than the laboratory personnel staff such as physicians and nurses have to be borrowed from other sections of the care setting whenever the fast track ER is overcrowded.

To mitigate the negative impacts of the initiative on other aspects of the care setting, we will ensure that we coordinate with primary care providers so as to address avoidable visits. Research shows that unavailability of a primary care provider is one of the reasons that results in avoidable visits (Guagliardo, 2004). Hence, the availability of primary care providers will ensure that patients are only recommended to visit the ER only when it is necessary. Apart from coordinating with primary care providers, we will also have a system to ensure that patients receive care in the appropriate setting. This way, we will reduce the negative impact that the fast track ER will have on other aspects of the care setting.

Strategies to Ensure that the Initiative Remains Viable

We have integrated some strategies into the fast track ER initiative to ensure that it remains a viable asset even when faced with dynamic environmental forces. Some of these environmental forces include increased number of patients in the fast track ER unit for basic health care needs rather than emergency services and sluggish economic climate that has led many people to be uninsured. These factors pose risks to the initiative as people may come to the fast track ER unit regardless of their ability to pay. This has necessitated the need to include efficient strategies to ensure that the initiative remains viable to the care setting despite these environmental risks.

Even if the environment shifts in unpredictable ways the initiative will still be a viable benefit to the care setting if the personnel continue to provide quality and timely services. However, the triage process needs to be efficient to ensure that only patients with emergency conditions come to the fast track ER unit (Quattrini & Swan, 2011). There will be thorough verification of patients information so as to lower the number of uncollectible debts from people who cannot be located. Also, patients will be provided with manageable payment plans and financial assistance to increase the likelihood of them paying for the services. This will ensure that the initiative is successful even with the presence of dynamic environmental forces.

To ensure the initiative remains a viable net benefit to the care setting certain strategies have to be implemented. They include hanging wall posters in the triage and clinical areas about the fast track ER unit, issuing pocket-sized laminated card of the fast track ER unit to each nurse. Also, sending E-mails to every staff to remind them of the forthcoming changes, hanging posters after the implementation to address questions about the fast track ER unit. The key to a successful implementation of the fast track ER is reinforcement. Therefore, after the implementation, the staff who made a smooth transition to the initiative should be recognized and rewarded.

Conclusion

The fast track ER initiative aims at reducing the extensive waits in emergency rooms and improve the overall flow of patients in the department of emergency. This is because if a person has a severe condition will be seen immediately, but those with less severe conditions or complaints will wait until there is a free bed and caregiver is available. Moreover, the initiative will see that service quality is improved, there is a reduction in the length of stay of patients and improved efficiency. This will see the satisfaction of the patients, nurses, doctors and even the administrators since the hospitals reputation will be improved. The dark side of the initiative are less and can easily be mitigated thus showing that the initiative will be of great benefit to the care setting with better reinforcement and implementation.

References

Guagliardo, M. F. (2004). Spatial accessibility of primary care: concepts, methods, and challenges. International journal of health geographics, 3(1), 3.

Hanson, W., Moore, J., Whitesides, C., Foxx, M., Hickman, J., Ramirez, M., & Jordan, E. (2014). Why go to the Emergency Room? A Patient Decision Making Process. International Journal of Management Excellence, 3(3), 480-486.

Hwang, C., Lipman, G., & Kane, M. (2015). Effect of an Emergency Department Fast Track on Press-Ganey Patient Satisfaction Scores. Western Journal Of Emergency Medicine, 16(1), 34-38. http://dx.doi.org/10.5811/westjem.2014.11.21768

Newcomer, K. E., Hatry, H. P., & Wholey, J. S. (2015). Handbook of practical program evaluation. John Wiley & Sons.

Quattrini, V., & Swan, B. A. (2011). Evaluating care in ED fast tracks. Journal of Emergency Nursing, 37(1), 40.

Rodi, S. W., Grau, M. V., & Orsini, C. M. (2006). Evaluation of a fast track unit: alignment of resources and demand results in improved satisfaction and decreased length of stay for emergency department patients. Quality Management in Healthcare, 15(3), 163-170.