Question

2.8 Using Exhibit 2-2, find a case study of a research example in which a clear statement of the management dilemma leads to precise and actionable research. (Hint: Visit research company websites; use a search engine to find examples.)

Answer 1

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2.8 Using Exhibit 2-2, find a case study of a research example in which a clear statement of the management dilemma leads to precise and actionable research. (Hint: Visit research company websites; use a search engine to find examples.)

I chose the research example of placing a physician in the emergency room triage to aid in the management dilemma of reducing emergency room wait times, reduction of ambulance diversion, and the increase of staff satisfaction. Based on exhibit 2-2, the research question is, will a physician in triage, as opposed to alternate staff, such as registered nurse or medical technologist, aid in the decrease of emergency room wait times, reduction of ambulance diversion, and the increase of staff satisfaction? Research design consisted of measuring median times of attending physician evaluation, median length of stay, number of patients left without being seen, and total time and days on ambulance diversion. Primary data collection and analysis were based on direct input in to an electronic medical record. Data sampling, analysis of times and length of stay were compared based on number of patients seen prior to physician in triage to the same number of patients seen after implementation of physician in triage. Based on two peer reviewed articles, each institution chose to add a physician in triage during peak hours, which also added an additional cost analysis review. Would the number of patients being seen and reduction in length of stay, allow for enough revenue to pay for the addition of a physician? Data collected in both scenarios indicate the answer is yes, the additional physician cost was in proportion to the cost associated in the reduction of patient wait times and better patient throughput.

Additional data indicated overall revenue for the hospital is also increased with the physician in triage implementation. Based on my own experience with physician in triage, the physician was given a timing matrix of 120 minutes from initial evaluation to discharge or hospital admission. For the most part, physicians have been able to keep to the standard 120 minutes, however, with patients with medical imaging orders, were not able to meet the 120 minute criteria, an unexpected pitfall. Additionally findings indicated the volume of medical imaging, such as CT and MRI, increased dramatically, which has resulted in conversations regarding insurance reimbursements and increased staffing during the off hours. Overall however, and consistent with the two peer reviewed articles, finding were consistent with decreased wait times, reduction of ambulance diversion, and reduction of ED stay times. Finally, for the any emergency room, the goal is assist in the care of a patient. The physician has his or her role and the Lord has his. "Worship the LORD your God, and his blessing will be on your food and water. I will take away sickness from among you…" Exodus 23:25

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