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Emergency room patients may increase at any time. Events, accidents, minor and major illnesses trigger ER visits. However, some patients visit emergency room because they do not have a primary care physician or what they believe is a bad pain, does not warrant a visit to the emergency room. Possible hospital challenges affecting ER issues may include decreased staff, miscommunication, and test delays. They must strategize how overcrowding can be managed. A few options include implementing tele type visits for patients to describe symptoms to a physician. Physician will advise regarding diagnosis and next steps. From personal experience, tele med was a successful experience. If I had gone to the emergency room, it would have been an all-day situation. Another option is designating staff to be bed czars. Their role is to supervise incoming ER patients. (Minemyer, 2017). These processes allow efficient movement to ensure patient registration and required testing. Hospital leaders should observe ER activities,   wait times and overcrowding.  


  In healthcare the number of patients requiring treatment at the same time can sometimes overwhelm the healthcare system and patients are required to wait to be seen by a physician, especially in the ED or urgent care facilities. This is because both arrivals and length of service time vary from patient to patient. There are times when the ED is idle because there are very few patients or no patients at all. Queuing system can be used to minimize costs.

           According to Ozcan, (2017) the main queuing model characteristics are: 1) the population source, 2) the number of services, 3) arrival patterns and services patterns, 4) queue discipline. Queue can grow infinitely or be limited capacity. According to the Poission distribution more than four patients in the ED would begin to overwhelm the emergency department because of the time required to see each patient.

            The number of physicians treating the patients can be increased to two physicians instead of one. As service capacity increases, so does its costs; service capacity costs are shown as incremental. As capacity increases, the number of patients waiting and the time they wait tends to decrease, so waiting costs decrease. (Ozcan, 2017). The goal is to determine the level of service capacity that will minimize cost. Hiring another physician will increase costs but more patients will be seen and decreasing waiting time which in turn decreases costs and increases profit. Its important to remember in healthcare quality should come before cost. Its better to have too many staff members working than not enough. The primary goal of every HCO should be to provide safe and effective care to their patients

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