In general health practice, health care providers and organizations are mandated to provide quality care to all. Despite this universal obligation, institutional and policy challenges hamper the goal achievement process. Such challenges make health organizations fail to achieve the desired performance benchmarks. Underperformance has huge implications since it makes health care organizations legally and ethically unfit to provide patient care. To improve performance, it is vital to be guided by local, state, or federal policies and institute practical interventions to address the challenges hindering performance. This policy proposal is based on CareM Medical Center’s underperformance in Bakersfield, California, and examines how to improve performance through policy interventions.
Although it is a practice requirement, it is not practical for health organizations to meet the required performance benchmarks all the time. Policy and practice guidelines are vital for giving an organization an operation reference point as formalized statements applying in a specific area of practice and non-mandatory recommendations respectively. When a benchmark shortfall occurs as local, state, or federal policies prescribe, creating policies and practices helps health organizations to overcome the shocks triggered by practice changes. They act as a reminder of what an organization should strive to achieve as the law and practice recommendations obligate.
In the case of CareM Medical Center, the issue of concern is the long waiting time in the emergency room (ER). The average waiting time should be forty minutes, but the facility’s waiting time is as high as 80 minutes, implying that the performance score is 50%. Such a performance has huge implications on the quality of care. According to Martinez et al. (2019), long waiting time leads to extended hospitals stays and increases patients’ mortality. Since many visits and lack of adequate beds exacerbate this problem in CareM Medical Center, registered nurses’ motivation is adversely affected due to increasing workload.
Due to the far-reaching effects of the problem, practical interventions are necessary. If the medical center does not make any changes, there is a huge chance of legal and ethical implications. Health care organizations must always operate as legally, ethically, and professionally mandated. The other adverse consequence of not making any change is reduced competitiveness. Zhang et al. (2017) postulated that the nurse-patient relationship is ruined when health care organizations fail to deliver as expected. Patients lose the facility’s trust and are likely to look for medical assistance in other facilities due to diminished trust. To avoid such impacts, it is advisable to act soonest possible.
CareM Medical Center can apply several strategies to reduce waiting time in the emergency department. Since the current benchmark metrics focus on patients with substance use disorder (SUD), there is a high chance that other assessment areas are being underserved. One way of changing the current situation is empowering nurses to be more capacitated to work. The current nurse: patient ratio in the facility’s ER is 1:5. California recommends a nurse-patient ratio of 1:4 in the ERs (Sharma & Rani, 2020). The addition of hospital beds is also a practical intervention. The medical center should also consider limiting patients’ flow to the ER by empowering nurses to admit patients after diagnosis directly.
Evidence-based literature is awash with suggestions for improving waiting time in the emergency rooms. Ravaghi et al. (2020) suggested that hospital expansion should be highly considered, and hospitals should not be regulated extremely. A fitting example of an extreme regulation is limiting admission capacity to the ERs. In the same case, emergency care should be restricted to patients with proven emergency problems. Admitted patients should not be boarded in the emergency departments; clearance should be as quick as possible (Chrusciel et al., 2019). Such strategies can prevent overcrowding in ERs and improve hospitals’ capacities of meeting all patient needs.
The proposed strategies can facilitate performance improvement in various ways. One such way is preventing RNs from being overwhelmed. Gutsan et al. (2018) suggested that high workloads to registered nurses can cause burnout. When nurses work within their limits, they are energized to respond to patient problems and make medication errors low. Another way of practice improvement is improved nurse-patient relationships. Treating patie
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