9 page essay on EMTALA law

Outline for paper on EMTALA (Emergency Medical treatment and Active Labor Act) 

 

Introduction of what EMTALA means and how it impacts cost, technology, aging population, increasing diversity of population and the workforce, and changing disease patterns and treatment 

Introduction: As a condition of participation in Medicare, the  1986 EMTALA law  requires hospitals to screen patients for emergency medical conditions and provide stabilizing treatment, regardless of their ability to pay. Hospitals found in violation of the law potentially face a $50,000 civil fine per incident and can be barred from the Medicare and Medicaid programs. The law also gives dumped patients or their families the right to sue the provider. 

 

1. Cost 

a. Uninsured patients  

i. Using emergency rooms for primary care  

1. Leading to financial distress and burdens on hospitals 

a. Closing of hospitals 

b. Decreased nursing and ancillary staff  

i. High patient ratio for nurses 

ii. Decreased quality care for patients 

ii. Undocumented immigrants, elective uninsured, and low socioeconomic population are now able to go to the emergency rooms without fear of being turned away 

iii. Illegal immigrants 

1. Using emergency room for any medical care 

2. They are not qualified for Affordable Care Act 

3. Will never follow up with a specialist, may utilize a free clinic.  

a. Risk their health by just using the emergency room  

 

2. Technology 

a. Electronic Health Records  

i. With the increased number of uninsured patients being seen in the emergency room due to the EMTALA law, hospitals must use the most efficient computer software to ensure all patients are being seen in a timely manner and offered a medical screening exam. 

b. Hospital equipment 

i. With the medical screening exam- includes diagnostic testing and blood work to rule out anything life threatening. For hospitals to work quickly and efficiently, they must have up to date equipment to keep up with the increased number of patients. 

ii.  

3. Aging population  

a. Patients living longer  

i. Nursing home patients still need to have the required medical screening exams 

1. Increased visits to the emergency rooms for chronic diseases 

a. Most nursing home patients that come to the ER require extensive tests due to their chronic diseases 

i. Leading to financial burden on hospitals 

1. Medicare does not cover readmissions within 30 days 

2.  

4. Increasing diversity of population and the workforce 

a. Hospitals are required to offer patients who do not speak English Translators or translator phones to obtain accurate medical information. It is pretty much the law that hospitals use translators because medical information may be misinterpreted. Diversity in the workforce is necessary for better patient outcomes (bilingual) 

b. When medical information is not translated correctly, there may be adverse outcomes: 

i. Patient chronic disease may be getting worse 

ii. Not receiving appropriate treatment 

 

 

Institute of Medicine Future of Nursing Report 

1. What type of nurse leaders are needed to shape the future 

2. How are the nurses and nurse leaders different and similar from 20 years ago 

3. How does globalization affect predictions of the future? 

a. Nurses in other countries, how are they viewing this issue? 

4. What are the recommendations for the Institute of Medicine 

a. Bachelor of Science of Nursing (BSN) 

i. How will BSN nurses and advanced practice nurses meet the patients needs 

 

 

 

My Reflection as a nurse on EMTALA on the law: 

-There has been increase in ER from minor to chronic diseases in the emergency room. People are utilizing the emergency room as their primary care physician.  Patients also do not follow up with specialists when being discharged from the ER. For example, when a patient is seen in the ER for abdominal pain, they are told to follow up with a GI specialist.  However, uninsured patients are not following up and continue to come back.  This leads to financial strains for the hospitals, longer waits in the ER for patients who are critical, and decreased quality care. This cycle also breaks the continuity of care for patients. Patients who do not have primary care end of "hospital shopping" which means getting repeat tests such as CT scans and blood work. Even patients who have the Affordable Care continue to use the ER for their primary care.  This may be due to patients not being approved for certain tests in a timely manner- Such as diagnostic imaging- CT scans and MRIs. It seems to me patients are taking advantage of the EMTALA law, especially the elective uninsured. The EMTALA law has given patients freedom to use the ER anytime, however this is impacting the quality of their care. As nurses and nurse leaders, we need to figure out a way to help navigate and educate patients on our complicated healthcare system to prevent patients to use the ER as their primary care.  

 

Conclusion: