Emergency rooms need better architecture. I started to think about this when I had to go to an emergency room a few years back. Reading this blog post, concerning “How do we decongest our overcrowded and dangerous emergency departments” (The Daily Dish by Andrew Sullivan) had me thinking of it further.
Essentially you have one room where everyone comes in and gets processed at a rate slower than they come in. You have people who aren’t really an emergency but who may have no where else to go (e.g. someone needing medical care at midnight). You may have people who really do need care but are wrongly ignored until it is too late. And I am sure there are lots of other problems as well.
I think doctors, nurses, patients and architects could work together to come up with a much better approach to dealing with this overwhelming situation. If you were to visit an ER, what would you likely see:a seating area,
nurse’s station, and then a secondary area for waiting/treatment.
Maybe there is a coffee shop. Perhaps there is a TV. Right now the situation is constrainted by the architecture of the ER room. and the ER process. I think both should change.
One way to change this is to look at what other organizations do to relieve this bottleneck. Retailers are a good example of this. They have essentially broken down their bottleneck: the checkout space. For example, car rental agencies have people who come to your car and check you other there. They are essentially extending the checkout space over a much larger area. Other retailers are providing people kiosks or scanners that people can use themselves which again speed up the process and eliminate bottlenecks.
And such services are being provided in the area of medicine. Where I live, the province provides Telehealth Ontario, which is free access via telephone to a registered nurse, 24/7. I have used this in the past when I have had a sick child and it has been a great benefit to me, my daughter, and the local ER which wasn’t clogged with my presence.
There needs to be more of this, however. Redesign the ER to allow for check in kiosks could speed up the process. Ceiling mount monitors to provide people with updates on how quickly things are going. Give out pagers to allow people to leave the ER , but then provide them with areas within the hospital or around the hospital that they could go to in order to have a coffee, a rest, a bite to eat, a diversion of some sort.
These aren’t the best of ideas: I think someone who works in ER and is really familiar with the problems there could also come up with better ideas. But better ideas are needed now.
(Great photo from Mark Coggins’ photostream at flickr.com)