Wait Times in Outpatient Centers Compared to Traditional Emergency Rooms
It is reasonable to suggest that many if not most people find themselves in need of urgent medical care at some point in their lives and until a few years ago, the traditional emergency room was the only option available. Over the past 20 years or so, though, there has been an explosion in the number of outpatient centers that provide a wide range of urgent medical care including various surgical procedures. This growth in the number of outpatient centers has resulted in an increased interest in determining how efficient these respective healthcare venues are in treating patients. To this end, this paper reviews the relevant literature concerning traditional emergency rooms and outpatient centers and proposes a strategy for recruiting and selecting a sample population to compare the average waiting times for each. An overview of the characteristics of the target and accessible populations is followed by a description of the proposed sampling strategy with its strengths and limitations. A discussion concerning the proposed recruitment plan is followed by a description of the inclusion and exclusion criteria that will be used for sample selection. Finally, an assessment of relevant contextual factors regarding the proposed setting of the study is followed by a summary of the research and important findings concerning the foregoing issues in the conclusion.
Characteristics of Target and Accessible Population
The scenario is probably familiar to any healthcare consumer who has sought medical care in a traditional emergency room. In all likelihood, there will be dozens of patients and their family members waiting for care and even if a consumer is fortunate enough to find an emergency room that is not crowded, the potential for new cases to arrive at any second means that waiting times can be extended indefinitely for non-life threatening cases. In this regard, Alijani and Kwun (2015) emphasize that, "Without a doubt, when looking at healthcare reform, we cannot overlook the problem of overcrowding and lengthy waiting times in most emergency rooms" (p. 2).
Lengthy waiting times in emergency rooms adversely affect the level of patient satisfaction (which is an area of quality concern for accrediting organizations such as the Joint Commission), but they also create a situation in which patients tend to experience higher levels of suboptimal clinical outcomes as well. For instance, Alijani and Kwun add that, "Long waiting times not only affect patient satisfaction, they increase the risk of death and hospital readmission for patients who have been discharged from the emergency department" (p. 2). Despite efforts to reform the healthcare system in the United States, most authorities agree that many Americans, especially those without health insurance, will continue to rely on emergency rooms as their primary source of medical care in the future (Alijani & Kwun, 2015).
Some indication of the extent of the problem can be discerned from the most recent statistics reported by the U.S. Centers for Disease Control which are set forth in Table 1 below.
Table 1
Emergency department visits in the United States: 2011
Category
Statistic
Number of visits
136.3 million
Number of injury-related visits
40.2 million
Number of visits per 100 persons
44.5
Number of emergency department visits resulting in hospital admission
16.2 million
Number of emergency department visits resulting in admission to critical care unit:
2.1 million
Percent of visits with patient seen in fewer than 15 minutes
27.0%
Percent of visits resulting in transfer to a different (psychiatric or other) hospital
2.1%
Source: National Hospital Ambulatory Medical Care Survey: 2011 Emergency Department Summary Tables. Tables 1, 4 at http://www.cdc.gov/nchs/fastats/emergency-department.htm
As can be seen from the statistical breakdown in Table 1 above, just over one quarter (27%) of the 136.3 million emergency room patients treated in 2011 were seen within 15 minutes of their arrival, and it is reasonable to posit that these cases were the most severe, arrived by ambulance and/or occurred during extremely rare periods of low demand. It is noteworthy that just around 29% of the emergency room visits shown in Table 1 above were injury related, indicating that the a significant percentage of healthcare consumers seeking care at emergency...
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