Emergency department overcrowding by pediatric patients is an issue that requires an effective solution. Complex and varied reasons cause constant visits that lead to overcrowding. Such factors range from minimal pediatric facilities in the hospitals to minimal access to primary care providers. They also include the influx of fully insured people who require immediate hospital services which results from emergency rooms. Currently, pediatric patients, mainly those looking for primary care services, mostly opt to pursue medical care in the emergency department instead of primary care providers due to inadequate asthma control. There is, therefore, a need to create a sustainable plan to reduce the visits.
Program Value
To resolve the issue, the best evidence-based model is the 5 A’s Behavior Change Model, whose elements include Ask, Advise, Assess, Assist, and Arrange. The model is significant because it will allow clinicians to engage pediatric patients in decision-making and realistic planning concerning their future health status. Medical caregivers can easily involve younger age patients to a minimum of three years in their health assessment process. Compared to other similar models, using the 5A’s makes it possible for such assessment to be carried between the patient and healthcare provider easily.
5A’s program should be scaled up because its model portions, namely, Ask, Advise, and Assess, support in identifying the pediatric patient variables by inquiring about the habits and frequency of behaviors that affect their health. Moreover, it benefits in advising whether the actions have either negative or positive effects on their health. The model also helps assess the patient’s readiness to reduce or quit the harmful manners (Beebe et al., 2019). After the behavior identification and goal setting process, the Assist stage of the model aids the clinicians in providing the necessary interventions.
Scalability
In terms of cost, the program is scaled up to approximately $1,110. The rate will involve 19 Nursing practitioners using 10 minutes of calls under the NP salary of 65 dollars per hour, therefore, totaling 205 dollars. This will be a cost-effective way to help many pediatric patients as compared to the previous methods. The return on the investments will be 5.41 for every 1.00 dollar spent. The process will take at least six months for scaling to be effective. The scaling will also increase awareness for the delayed or problematic outpatient follow-up for primary care. The program will also be scaled up by administering the inhaled corticosteroids from the nurse Emergency Department in the case indicated for symptoms control.
Sustainability
The program has a high potential to be sustainable, with several strategies involved. The medical practitioners involved call the patient they are interested in serving within 24-48 hours of every visit. Therefore, it will be quite possible to add an extra commitment to pediatric asthma follow-up phone calls. Some stakeholders, including Emergency Specialist Physicians Medical Associates, have already shown interest in the program, acknowledging its significance. The sustainability measures taken will be implemented through actively involving the nurse practitioners in the phone call process of communicating with the pediatric patients.
The continuous visits to the emergency department can be effectively solved by practicing the 5A’s program. The program makes it easy for medical caregivers to carry accurate assessments to pediatric patients. The approach has proven to resolve the complex and valid reasons that make pediatric patients constantly visit the emergency departments. The program is easily scalable, and it is also sustainable, making 5A’s the best solution to Child Asthma Emergency Department Visits.
Reference
Beebe, G., Novicevic, M., Popoola, I. T., & Holland, J. J. (2019). Entrepreneurial public leadership: 5A’s framework for wellness promotion. Management Decision.