DPI project manuscript 6 DQ 1

10 Strategic Points

Comments/Feedback

Broad Topic Area

The use of advanced practice providers in triage to improve waiting times in emergency departments.

Literature Review

a) Background of the problem/gap;

I. The waiting times in the emergency departments are mostly fueled by the large number of the patients seeking the requisite medical services. The large number of such patients causes overcrowding in the emergency department. The overcrowding is a major problem in the emergency department even in the global arena (Di Somma, Paladino, Vaughan, Lalle, Magrini, & Magnanti, 2015).

II. The mismatch between the demand for the emergency services and the available resources has greatly contributed to the overcrowding within the emergency departments (Murphy, Lietz, &Jordan, 2012)

III. When advanced practice practitioners are placed in the emergency department, the quality of care as well as reduced overcrowding become the order of the day (Bahena & Andreoni, 2013; Imperato et al., 2012).

b) Theoretical foundations;

I. Demand and capacity variation model by Eriksson (Bergbrant, and Berrum-Svennung, 2011)

II. The co-management model in healthcare (Norful, Jacq, Carlino & Poghosyan, 2018)

c) Review of literature topics with the key themes;

I. Critical Care Medicine Advanced Practice Provider Model at a Comprehensive Cancer Center: The increasing demand for meeting the critical medical services are prompting for the increment of the number of the advanced practice providers (APPs). The role of APPs, especially in the ICUs, cannot be underestimated (Paton, Stein, Agostino, Pastores, & Halpern, 2013).

II. Frequent Overcrowding in the U.S. Emergency Departments: Overcrowding in the emergency departments is a serious problem which affects not only the US but also the other countries across the world. This overcrowding cannot be limited to the county or public hospitals since it has been evident even in both the private and academic hospitals within the urban and rural areas (Derlet, Richards, & Kravitz, 2001).

d) Summary;

I. Gap/problem: There is a need to reduce the waiting time or delays in the emergency departments.

II. Prior studies: The prior studies have proved that the involvement of advanced practice providers not only reduces the delays in the emergency departments but it also leads to provision of a quality care.

III. Quantitative application: Instruments and sources of data exist to collect numerical data on the value of advanced practice providers in emergency departments.

Problem Statement

While the literature indicates that the involvement of advanced practice providers helps reduce the delays in the emergency departments, it is yet to be known how they help to reduce these delays.

Clinical/PICO Questions

How effective is the use of Advanced Practice Providers in triage in improving waiting times in Emergency departments?

Sample

Location: District of Columbia.

Population: Three county hospitals.

Sample: 30 adult patients receiving the care at the emergency department.

Define Variables

Dependent variable: The waiting times.

Independent variable: The Advanced Practice Providers.

Methodology and Design

This project will use the quantitative methodology with a descriptive research design

Purpose Statement

The purpose of this quantitative descriptive research study is to assess how the advanced practice providers help reduce the waiting times in the emergency departments. The advanced practice providers will be defined as the assistant physicians as well as the nurse practitioners. The waiting time will be measured by the number of hours or even days that a patient queues in the emergency department prior to getting the requisite medical services.

Data Collection Approach

This study will use questionnaires which will be provided to the participants to fill, but for those without literary skills, oral questions will be posed.

Data Analysis Approach

Descriptive statistics will be used to summarize the sample descriptive data. The data will then be presented in tables and pie charts.