IMPLEMENTATION OF AN EDUCATIONAL VIDEO PROGRAM IN EMERGENCY ROOM TO IMPROVE THE TRIAGE WAITING TIME TOLERANCE
The emergency department is where critical patients are taken before met healthcare team. The emergency room plays a prime role, acting as a holding place due to increasing number of patients at the hospital. Prolong waiting time is a prime recipe for crowding in the emergency department. A crowded emergency department significantly delays the delivery of timely health care services. Unlike the other specialty services, the emergency room physicians deal with every health care issue presented to them (Ajami, Ketabi & Mahmoodabadi, 2013). Patient services aim at providing both inpatient and outpatient care services. The hospital offers highly specialized emergency care services among others (Seha. ae, 2018). Customer care is the third level of service delivery by the hospital which aims to provide adequate customer services to the clients, prompt feedback and ensures high-level customer satisfaction.
Al-Ain hospital operates with over 30 specialist departments which are served by an approximate 300 doctors; the hospital has 3 medical clinics with an inpatient capacity of over 20,000 and over 32,000 outpatient clinics (Seha. The mortality rates have been high. In addition to the threat to the life of the patient, long triage waiting time has been associated with overcrowding at the hospital waiting rooms (Rachlis, 2005). More often patients left before consulting the physician, a delay in delivery of medical care service, and eventually, most patients were dissatisfied. Given the traditional appointment time of 10-15 minutes, the physician usually lacked sufficient time to address all the presented medical concerns of the patients. Due to impatience, the Patient-doctor consultations ended up with incomplete information and unanswered questions since physicians spend a good part of the discussion eliciting the symptoms and signs of the patient to establish the diagnosis (Imperato, Morris, Sanchez & Setnik, 2013).
LITERATURE REVIEW AND METHODOLOGY Introduction Given the traditional appointment time of 10-15 minutes, the physician lacks typically sufficient time to address all the presented medical concerns is of the patients (Imperato, Morris, Sanchez & Setnik, 2013). This caused the physician to extend beyond the set duration. Patients have described the long triage waiting times as intolerable during their clinical encounters and acts as barriers to receiving healthcare services (Houston et al. The increasing triage waiting time has been demonstrated to be among the significant solitary obstacles to the evidence-based exercise in the provision of prime healthcare (French, Lindo, Jean & Williams-Johnson, 2014). Triaging, at the waiting room entails the evaluation of the patients to establish the level of their medical need to determine the most appropriate course of action (Khazaei et al.
Furthermore, it is anticipated that the use of educational videos in the waiting room will increase the clients’ contentment with the healthcare facilities of the hospital as well as the hospital staff (Reid et al. While the triage waiting time may be extended, the engagement that the patient gets from watching the video will lift the anxiety of waiting and the resulting impatience, and in the end, they will feel satisfied with the healthcare services of a facility (Amina et al. According to a survey, most patients feel that the quality of healthcare and physician encounters is directly related to impression during the triage waiting in the waiting room (Sherwin, McKeown, Evans & Bhattacharyya, 2013). Additionally, these videos are often informational, and their role in distracting the patient further eases their stress (Sun, Brinkley, Morrissey, Rice & Stair, 2004).
Although meeting the expectations of the patients during medical care increases clients’ satisfaction, studies have also demonstrated that the use of the health education videos reduces patient anxiety in the waiting rooms during triage waiting (Leong & Horn, 2014). Moscelli, Sicilian, and Tonei (2016) carried out a study to examine how waiting time affects the quality of healthcare services. T-test and Mann-Whitney approaches were used to how the triage wait time influenced the quality of service offered at the Shahid Rajeev hospital in Karaj. Research outcome indicated that there was a substantial variation between test and control group on wait time from getting treatment service and client’ contentment. They concluded that triage could suggestively lower wait for time interim between clients’ arrival to the emergency department to receive treatment service and the quality of service.
Increased triage waiting for time tolerance in the emergency department may help healthcare personnel to have a better performance and improve patients’ satisfactory. The study suggested that healthcare personnel in the emergency department were adequately trained and that prolonged waiting time at the ER was due to other factors. Ajami, Ketabi, and Mahmoodabi (2013) investigated how simulation can be used to minimize wait time in the waiting room at the Ayatollah-Kashani Hospital. The program could allocate time a physician could take to attend to a specific customer, the patient arrival interval and approximate time a respondent could take in an emergency department. They concluded their study showing that introduction of simulation machine can have a significant impact on the overall time a client can spend in the emergency waiting room.
They further stated that time taken by a patient in the emergency department is determined by several factors. The study will primarily focus on the Al Ain hospital clients’ experience and behaviors. Just like any other research method, qualitative phenomenology study has some advantages and limitations. Overall, phenomenology method can provide a rich and detailed perception of human experience. Following are some of strength and weakness of phenomenology research method. Advantages of Phenomenological Research The method gives a unique perspective. More often it is difficult for participants to express themselves following several factors such as age, cognition, language barrier, and embarrassment. The approach requires the researcher interpretation, making phenomenological reduction a vital component to minimize assumption, biases and perceived ideas about the event.
Observer or investigator bias is difficult to define or detect. Presentation of the research findings is difficult if not impossible. More often phenomenology research results are highly qualitative, which make it hard to present finding in a proper format practitioner can consider being useful. The Al-Ain Hospital is located in the central part of Jimi district and is linked to the University of United Arab Emirates as a training center. The hospital sits in old buildings from the 70s. However, a new building for the hospital is under construction. In 2007, the management of the hospital was taken over by the Medical University of Vienna. Al-Ain hospital operates with over 30 specialist departments which are served by an approximate 300 doctors; the hospital has 3 medical clinics with an inpatient capacity of over 20,000 and over 32,000 outpatient clinics which make it an ideal location for our study (Seha.
Patients below 18 years old and have no adults accompanied them to the hospital will be excluded from the study. Similarly, the patients who will not be triaged will also be excluded as well as the acutely ill patients who will be directly transferred to the stretcher on arrival will not be included in the study. Inclusion Criteria The study will include only the patients who will visit the Al Ain Hospital between October 2018 and late January 2019. The patient must be a citizen of United Arabic Emirate and speak either Arabic or English. Only those in triage waiting rooms and are of age 18-50 years old will be studied. The advantage of using Observation It is the simplest data collection method since it requires little training and technical knowledge.
Helpful for hypothesis formulation, by viewing an event repeatedly, the researcher may get well acquainted with the observed. I will be able to understand respondents’ habits, likes, dislikes, perception, and problem. Well versed with information about patients, it will be easier to formulate a hypothesis about them. The method provides a higher level of accuracy. Patients have many individual manners or undisclosed activities that are not readily observed or noticed. Not all events are exposed to being viewed, can only be viewed when the investigator is at hand. Not all happenings lend to observational research. Most of the social phenomenon such as emotions, frustration, and feelings are abstract. Lack of reliability. Ethical consideration Before commencement of this project, data collection, analysis, and findings of this project proposal submitted to quality assurance and ethical the organization's ethics committee for approval (Kasssan, 2008).
All the interviews will be informed that their response will be confidential, anonymous and voluntary. They will be required to sign an informed consent form to partake in the research. Outcome measures The primary outcome measures will be the triage tolerance of the patients, overall time taken by a doctor to listen to a patient and the overall satisfaction of the patients with the healthcare services including the health education role-play videos. This will be measured by observing the people in the triage room with the role-playing video going on. The waiting room provides the ideal opportunity for providing the patients with healthcare education through educational videos. Majority of the patients may desire to access healthcare information, but they are not sure or have not had the opportunity to access the information.
The use of the educational videos during triage waiting will keep the patients captivated, occupied and engaged and as a result of their tolerance to the increasing triage waiting time will also increase (Gignon, Idris, Manaouil & Ganry, 2012). References Osadchiy, N. , & Kc, D. Measuring and analyzing waiting time indicators of patients’ admitted to the emergency department: a case study. Global journal of health science, 8(1), 143. Ajami, S. , Ketabi, S. , & Mahmoodabadi, H. , KIMIAIE, A. H. , & SALIMI, R. Evaluation of factors affecting emergency department length of stay. Theunissen, B. , & Poeze, M. Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department. European Journal of Trauma and Emergency Surgery, 40(1), 87-91. Setoodehzadeh, F. , Petramfar, P. The waiting room: vector for health education? The general practitioner’s point of view.
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