Needs Analysis for Change
All organizations need to embrace change to keep up with the new advances that transform various ways of operations. In healthcare systems, change has been the most significant way these organizations use to identify new styles of meeting patient outcomes (Sartini et al., 2022). However, before any assigned or approved the change, the organization needs to carry out the need analysis to show some of the changes required in an institution. As a result, the purpose of this assignment is to carry out a need analysis for change at Katherine Shaw Bethea Hospital located in Lee County.
The economic Issue
In Lee County there is a rising need to have an urgent care facility that accepts all insurances. The county’s poverty rate of 20% shows that the community is facing an increasing Medicaid population that would require an urgent care facility that accepts most of the insurance (Lee County, 2018). As of now, the only urgent care in the area is a private facility that does not accept Medicaid. The patients who visit the facility for non-emergent needs or lack primary doctors are forced to seek attention from the emergency department. This increases the population of patients in the emergency department for non-emergent patients.
Rationale
Developing an urgent care facility that accepts all insurances in Lee County will significantly impact the quality-of-service delivery in rural areas. In most cases, rural areas are left out in the planned integration process, leaving them in dilapidated conditions that are unable to meet the required healthcare outcome. Again, the increasing Medicaid population in rural areas is significant and requires better healthcare attention because of their vulnerability. All these are important indicators of the need to construct urgent healthcare facilities in the county.
KSB Hospital is not alone in treating an area with a large population living in poverty, but one difference is that there is not an urgent care facility that accepts Medicaid, which is the insurance most people in poverty have in Lee County (Lee County, 2018). The main objective of an ED in Lee County is to treat emergency and urgent cases. Still, due to malfunctioning health services in communities, there is a rise in the improper use of emergency departments. The Medicaid population depends on the program as the common payer source for ER visits. These visits are higher in rural and urban communities (Lee County, 2018). The primary insurance of the Medicaid is not accepted in the available urgent care facilities leading to overcrowding in ED.
Economic Disparities
The population in rural areas is generally aged, implying that they heavily depend on Medicaid insurance for emergent and non-emergent care. This population also constitutes many people who depend on pensions and children working in urban areas. Therefore, the overall income of the population in rural areas is not reliable and strong as compared to the situation in urban centers (Hess et al., 2018). This difference implies that the population in rural areas tends to use the available insurance to obtain any form of healthcare service. However, the lack of urgent care facilities that accept a wide range of insurances forces them to receive these services from the ED, which results in overcrowding (Sartini et al., 2022). Overcrowding affects the quality of care, increases the risk of patients having adverse outcomes, and increases the risk of errors.
The increase in cases of overcrowding in ED does not only affect the quality but also increases the chances of nurse burnout. In most cases, the population of nurses working in rural healthcare communities is few because of the comparatively low patient population recorded daily (Cho & Steege, 2021). However, the reduced number of nurses is always commensurate with the population of patients resulting in the required nurse-to-patient ratio. In the case of KSB, nurses in the emergency department will be forced to work for longer hours and attend to many patients to ease the pressure on the department. This situation affects the workout of the nurses and reduces their job satisfaction. Therefore, the current situation at KSB affects not only patients but also nurses, who are the main pillar of service delivery in rural healthcare centers.
Potential Change
The desired change is to have an additional urgent care facility that will accept the insurance that many people have within the community. The current influx of patients in the ED results in overcrowding because they do not have primary doctors that can attend to their non-emergent issues at their homes. The development of a new urgent care facility would come at a high financial cost but with a better result for the community (Sartini et al., 2022). For instance, adding an urgent care facility would reduce overcrowding as many patients can use their insurance to access healthcare services. This facility would give patients more than one option of receiving better healthcare services.
Outcome and Opportunities for Growth
The current proposed plan at KSB hospital is to build an urgent care facility. This process will have a financial impact on the hospital, but the outcome would solve the current problem at the facility (Sartini et al., 2022). Developing the plan to build this facility will open up the clinic to more patients as they can receive quality care. The outcome of the new facility will be seen in the increased quality and low workload among nurses.
Conclusion
A significant increase in the number of patients in the ED leads to overcrowding all over the county. This pressure on the ED would affect healthcare quality and increase nurse workloads. Implementing an urgent care facility that treats patients of all financial backgrounds is necessary and will positively impact the community.
References
Cho, H., & Steege, L. M. (2021). Nurse fatigue and nurse, patient safety, and organizational outcomes: A systematic review. Western Journal of Nursing Research, 43(12), 1157-1168. https://doi.org/10.1177/0193945921990892
Hess, J., Miller, B., Paiva, W., Stroup, J., & Fong, E. (2018, March 15). Comparison of emergency room utilization for non-emergent purposes before and after the implementation of the affordable care act. OSU Center for Health Sciences Research Profiles. Retrieved from https://scholars.okstate.edu/en/publications/comparison-of-emergency-room-utilization-for-non-emergent-purpose
Lee County Community Health Needs Assessment (CHNA) report. (2018). Retrieved from http://www.leecountyhd.org/files/3916/6128/0584/LEE_CO_CHNA_Report__Oct_2018_web.pdf
Sartini, M., Carbone, A., Demartini, A., Giribone, L., Oliva, M., Spagnolo, A. M., Cremonesi, P., Canale, F., & Cristina, M. L. (2022). Overcrowding in emergency department: Causes, consequences, and Solutions—A narrative review. Healthcare, 10(9), 1625. https://doi-org.library.capella.edu/10.3390/healthcare10091625
