Strategies to Enhance Patient Satisfaction

Healthcare organizations provide nursing services centered on multiple theories. For instance, the Open Systems Theory established in 1978 by Katz and Kahn considers the healthcare organization as social systems divided into interconnected subsystems (Meyer & O’Brien-Pallas, 2010). Meyers and O’Brien-Pallas (2010) provide that these interrelated subsystems include outputs, throughputs, inputs, negative feedbacks and a cycle of events. The primary care hospital environment has various units that handle different cases including the intensive care, intermediate care, medical-surgery, emergency department (ED) etcetera. This paper delves into system theory in the emergency department, identify goals and challenges in this department and establishes an appropriate structural outcome.

In the emergency department, the inputs include financial resources, supplies, and staffing needed for the unit to be functional. The emergency department is in operation all day and night and needs sufficient nurses and subordinate staff to give a throughput of services. More inputs in the ED include the material required to provide nursing intervention that can be bought from various outside vendors (Kamal, Barnard, & Christenson, 2014). Some of the materials purchased include paper. Pencils, pens, glucometers, intravenous fluids, and gauze. The hospital organization develops a unit budget for each hospital department to ensure they can purchase these supplies.

The unit uses all the inputs to create products, and its maximum rate of production is the throughputs. For instance, in the emergency department, the throughput entails all the nursing services provided by the team to the patients who seek their services (Kamal, Barnard, & Christenson, 2014). The output entails the number of patients that the team can give services to after using the inputs. The service output in the emergency department creates revenue after the patients pay for the services (Kamal, Barnard, & Christenson, 2014). The health organization then utilizes the revenue to buy more inputs and support the unit resulting in a continuous cycle of service provision.

Negative feedback or organizational performance indicators establish if the subsystem is staying on target and functioning properly. The performance indicators keep the organization in check and ensure it does not fall off on its target and meets its goals (Kamal, Barnard, & Christenson, 2014). In the emergency department, emphasis rests on various quality performance measures including patient and employee satisfaction, patient throughput, and monitor department throughput.

The biggest problem that the emergency department is grappling with include overcrowding. The ED faces the challenge of increasing number of patients and significant numbers of admitted patients next in line to be transferred to an inpatient bed (Kamal, Barnard, & Christenson, 2014). Delays in treating patients with severe conditions result in dissatisfaction, patients backlog, insufficient management of serious pain, and increased rates of mortality.

However, ED might be failing because of system issues beyond its capacity including other sections of the system failing to provide socioeconomic and psychosocial supports, shortfalls in the community primary care system, or even the patients being able to get better services elsewhere. The Input-Throughput-Output conceptual framework is largely employed to depict the overcrowding issue in the ED (Kamal, Barnard, & Christenson, 2014). The input component is all about the emergency services demand affected by timely access to community and primary services as well as the prevalence of mental illnesses, trauma, chronic illnesses, and acute illnesses. The percentage of individuals who are vulnerable based on socioeconomic aspects influence the input component as well. ED throughput component is all about the efficiencies in the department and the patient processing capacity (Kamal, Barnard, & Christenson, 2014). Throughput is affected by factors like staff resource availability, physical space, and having efficient processes. The output segment mirrors how the clients move out of the emergency department, and factors such as access to community services like home care, and availability of inpatient beds influence the process.

Desired Outcome
The overcrowding in the unit poses a threat to the timeliness, safety, and quality of emergency care (Schoenenberger et al., 2016). The desired outcome is the proper management of demand and capacity in the hospital emergency department (Kamal, Barnard, & Christenson, 2014). As such, there will be efficient patient flow, minimized delays, and increased patient outcomes.

Goals and Objectives
The primary objective is to ensure efficient flow through the emergency department which is crucial for resource efficiency, safety, and compliance with government targets. The process also entails understanding and implementing interventions aimed at reduction of demands, management of throughput, and expediting output (Kamal, Barnard, & Christenson, 2014). The input solutions are focused on removing inappropriate users especially those who seek ED services unnecessarily. Throughput solutions focus on determining ineffective processes such as the triage and encouraging the introduction of engineering methods which assist in redesigning systems like streaming. Output solutions focus on reducing delays at patient discharge like utilizing the discharge lounges.

A systems approach which crosses boundaries can be helpful in developing advanced public policies which offer the resolutions to the overcrowding in the emergency department. The aspect of sharing of data between hospitals, census data, and ministries provides policymakers with understanding the functionality of the system works and supporting evidence-based policy development (Kamal, Barnard, & Christenson, 2014). It is also important to address the hospital leadership issues. Some of the procedures that will ensure better patient flow in the ED and optimize efficiency include coordinated surgery schedule whereby variability in admission is managed (Schoenenberger et al., 2016). Coordinated bed management whereby a bed czar accounts for inpatient beds and works with housekeeping make sure that the bed turnaround is rapid. Developing clinical decision units (CDUs) or Observation Unites to determine if admission is necessary. Unit Assessment Tools can be utilized to establish and track the capacity of the different hospital units. Coordinated patient discharge expedites the process, improves bed turnaround, and aligns bed demands with vacancies accurately.

Professional standards promote, guides, and directs professional practice. Nurses should remain professional and accountable for their practice. In this regard, the relevant professional standards entail
(1) the healthcare providers being professionally responsible and accountable for maintaining the standards of nursing practice and professional conduct (Kamal, Barnard, & Christenson, 2014).
(2) Providing knowledge-based practice by consistently applying proper nursing judgment, skills, and knowledge
(3) Providing patient-focused services
(4) Understanding, upholding, and promoting the ethical nursing standards.