Systems theory provides a meaningful approach to examine challenges in the healthcare organization and address problems in nursing and healthcare. The method can help determine a problem and formulate a solution that will address the challenge by viewing organizations as open social systems that must interact with their environments to survive ( Meyer & O’Brien‐Pallas, 2010) . A healthcare organization is a free system with characteristics of input, throughput, output, feedback, and coordination to achieve effectiveness. It depends on their environments for essential resources, including patients who buy the services, employees who provide labor and government providing the regulation. This paper will focus on the emergency department within a healthcare organization that is responsible for providing critical care to patients. It seeks to address the problem of overstretched services due to inadequate staffing and lack of functional equipment in an emergency department to fulfill the need for patient care. The paper will use systems theory to describe a department in the organization, define a problem and how to solve it.
Identified Department
The emergency department is a crucial aspect of any health facility responsible for providing medical and clinical surgical care to patients who need immediate attention. Physician within the emergency department deals with all urgent issues arising within the hospital department that require immediate attention. The emergency department provides treatment for all injuries and illnesses that may be considered life-threatening. The staffing ratio in the emergency department on a day shift is six patients to one physician, with three nursing aids supporting physicians during the day and two during the night, making them overstretched. At the same time, the unit has outdated equipment that increases wait time and affects the efficiency ( Aldridge et al., 2016).
Delegate your assignment to our experts and they will do the rest.
The organization has an open system comprising of interacting subsystems that transform inputs to create service. Systems theory approach can be used to understand the emergency department by considering the relational structure for reconciling research areas related to staffing and work environments. The description of the emergency environment thus contains aspects of inputs, throughput, output, the cycle of events and negative feedback ( Meyer & O’Brien‐Pallas, 2010) . Input in emergency departments refers to people, resources, materials, and information used within the organization. The nursing staff and care recipients can ensure smooth inflow of data from the external environment to help improve care provision. Materials for the department include medical supplies of all the items needed to perform medical operations. Resources can entail funding for the healthcare going into the emergency departments to help acquire supplies and other equipment
Secondly, throughput in emergency services refers to the aspect of transforming energies within the department by reorganizing inputs. It, therefore, refers to the care services that nursing professionals and physicians offer within the emergency department that are essential for treatment and health promotion. Some of the facilities within the emergency department include acute care for individual brought with injuries, patients with cardiac arrest, trauma or any other chronic illness ( Lee et al., 2015) .
Furthermore, outputs are the patient volume and quality of care provided within the emergency department. This department deals with a variety of health conditions and achieves production with a continuous flow of patients in and out without delay. The organization produces output by having enough staff and an efficient model of service delivery as well as a large capacity that accommodates increased demand ( Meyer & O’Brien‐Pallas, 2010) .
Output can also be in the form of revenues and activities coming from the provision of care. Increasing the efficiency and patient experience can build a reputation and increase the demand for care services. Accreditation of the institution can be one way of building a reputation, which is acquired after offering quality service. The organization should also look towards reducing negative feedback from the emergency department, which can arise due to delay, readmissions or longer hospital stays based on the nature of services ( Lee et al., 2015) .
The identified Problem
The problem identified in this department is congestion and overstretching of the emergency department beyond its capacity ( Lee et al., 2015) . The number of patients in need of critical care, as well as non-urgent problems, has been increasing while the number of beds and nurses to take care of the increased numbers remains constant. As a result, there is congestion within the emergency department stretching the services beyond capacity, and physicians are unable to absorb this surge in demand. The situation can be critical in the event of a mass casualty incident due to limited hospital beds, where patients have to wait for hours in emergency rooms until a vacant bed is available, exerting pressure on resources and personnel ( Aldridge et al., 2016).
According to the systems theory, the problem faced within the department is throughput where it is not useful to meet the demand for care services. Overstretching of bed capacity and congestion due to high demand and limited hospital beds affecting throughout. There is also a factor of inefficient coordination mechanisms that result in bottlenecks and delays in attending to the patient needs ( Roslan et al., 2014) . Coordination mechanisms between the laboratory and emergency department are ineffective due to lack of proper monitoring system, often resulting in bottlenecks and delays attending to the needs of patients in critical condition. As such, nurses have to work for more extended hours to meet the demand for emergency services due to understaffing, which affects the ability to work efficiently.
The mission of the organization is to serve patients with convenient and compassionate cost care, but the overstretching affects the efficiency of an organization in providing. The overstretched is seen in the form of the department being under-staffed and lacking enough beds to hold patients. As such, more patients are left on the waiting line before getting into emergency departments despite being in critical conditions ( Aldridge et al., 2016) . At the same time, the overstretching has affected work conditions at the emergency departments making them undesirable for both patients and physicians. There is also a lack of technological advancements to reduce waiting time and nurses rely on manual systems to handle patient needs. As such, there is a need to incorporate more advanced equipment within the department that will help provide effective treatments to patients
How to address the problem
This problem can be solved by implementing several policies and strategies in the organization to reduce crowding due to high demand. The plans entail hiring additional nurse practitioners, increasing bed capacity and enacting policies that facilitate how practitioners work. Increasing staffing ensures more personnel to deal with increased demand and ease the pressure and enhance throughput ( Aldridge et al., 2016) . This can help address the delay in emergency departments. The organization can also focus on reducing waiting time in the emergency department as one way of reducing congestion and overstretching of emergency services.
The goals and objectives of the remedies include ensuring right patient to physician ration that meets industry standards, increase bed capacity by 20 percent, reduce the time taken in the emergency department by ten percent and ensure a steady flow of patients within the emergency department without delay. These goals will facilitate the formulation of policies to guide the nature of service delivery. Systems can be enacted through a change of regulations that streamline financing, staff deployment and improving emergency services ( Roslan et al., 2014) . Additional funding will be needed to ensure the emergency department meets the rising demand and expand the facilities.
Relevant professional standards
Physicians in an emergency department have to attend to a specific number of patients per hour, often two. In this regard, having more patients increases pressure on physicians to offer care which affects their efficiency in working. At the same time, the number of beds required in a hospital determines its ability to demand emergency services where a high number of beds increases throughput and enhance service delivery.
Addressing the problem of overstretching of resources and overcrowding of patients in the emergency department can help achieve the mission of improving the quality of life and care in the organization. The success of the organization is dependent on its ability to provide quality services and addressing challenges in the emergency can give an edge and help achieve its mission ( Lee et al., 2015).
Conclusion
In conclusion, emergency departments are critical areas of a healthcare organization that requires a supportive environment to ensure sustainability and yield outputs. Efficient services are crucial in their emergency department to assure patient satisfaction. However, these services can only be achieved with enough equipment and personnel, with an overstretched capacity due to understaffing and limited bed capacity. The problem in this paper falls under throughput in a systems theory where the department is unable to meet the output demands. The solution to this problem entails the use of policies and strategies that will ease external pressure and increase its capacity.
References
Aldridge, E. S., Rogers, I. R., Bailey, P. M., & Rogers, J. R. (2016). Emergency department ‘undercrowding’is associated with decreased waiting times. Emergency Medicine Australasia , 28 (3), 268-272.
Roslan, S., Tahir, H. M., Nordin, N. A. M., & Zaharudin, Z. A. (2014, September). Analyzing patient's waiting time in emergency & trauma department in public hospital-A case study. In AIP Conference Proceedings (Vol. 1613, No. 1, pp. 39-44). AIP.
Lee, Y. J., Do Shin, S., Lee, E. J., Cho, J. S., & Cha, W. C. (2015). Emergency department overcrowding and ambulance turnaround time. PloS one , 10 (6), e0130758.
Meyer, R. M., & O’Brien‐Pallas, L. L. (2010). Nursing services delivery theory: an open system approach. Journal of Advanced Nursing , 66 (12), 2828-2838.
