Medical technicians such as respiratory therapists can ease the strain on busy E.R. doctors.
Management philosophy plays a large role in how effectively a hospital's triage room operates. With the ever rising costs of equipment, staff in hospitals and other medical facilities are under pressure to focus on the bottom line. However, both the Hippocratic Oath and the ethical traditions of most cultures require a more humanistic approach be taken. That isn't to say patients shouldn't pay for their medical services, only that the terms of payment should be negotiated after the patient is out of danger. Fortunately, hospitals with overly restrictive management philosophies are in the minority. The more immediate and pressing problems facing triage centers of today are a booming population and the deficit in both doctors and skilled technicians.
Facility Based Triage Difficulties
The key difficulties faced in triage situations are those of overcrowding and long wait times. Designating a nurse specifically for managing the waiting area can cut down on patients suffering compounded injuries due to delay in treatment. The role of this waiting room nurse is to frequently reassess patients, placing patients who fail to stabilize before others in line. As frightening as it is to believe, some triage centers employ a largely first-come, first-served policy, which in worst-case scenarios can lead to the death of patients. Frequent reevaluation of those in the waiting area is also important for avoiding initial misdiagnoses of the severity of the problem. If possible, having a waiting room-only physician can be vital, since even the best trained nurse is ill-equipped to diagnose all patients.
Another easily controlled factor in the efficiency of a triage center is the time it takes to move from the triage to the actual bed itself. Bottlenecks occur for a number of reasons; in some cases the facilities themselves are too small for the population they serve. The onus is on upper management to expand the facilities to meet the rising need. Triage centers need to have plans in place for transferring patients to nearby facilities in case of an unexpected massive influx of patients. Such an influx can be caused by any number of disasters.
Importance of Nursing Staff
Another possible cause of bottlenecks is a lack of nursing staff. Having enough nurses makes moving incapacitated patients that much quicker. Nurses who will be administering triage protocols require special training beyond that of the standard duty nurse, centered around improved communication skills. It is also imperative that these frontline triage nurses are capable of withstanding the higher pressure environment presented by patients arriving constantly.
Technicians Can Reduce ER Wait Times
In cases where doctors are in short supply, medical technicians can help to bridge the gap. For example, in cases such as asthmatic hospitalization, a respiratory therapist can often resolve the problem as well as a full-fledged doctor can, leading to quicker emergency-room turnarounds and reducing the strain on overall infrastructure. A pain-management specialist can also be useful in dealing with patients who have become agitated due to the pain caused by their injuries.
Tags: triage centers, waiting area