Understanding the ER

Understanding the ER

In an emergency, no patient wants to wait to be seen. It is indeed the most common complaint from patients that waiting times are too long. Waiting times, however, are a complex equation to solve from both a medical, administrative and cost perspective, considering patient satisfaction and overall experience.

ER Consulting Inc. has implemented numerous initiatives to assist in reducing waiting times and currently has one of the shortest average waiting times in the industry. ER Consulting Inc. uses CareFirst, a system designed exclusively to reduce waiting times and improve overall throughput times.

Waiting times are challenging to manage for many reasons. The very nature of emergencies is such that they are unplanned and therefore planning staffing requirements is always a challenge. Seasonality, surge periods, and the severity of patients’ conditions all influence waiting times. With considerable pressure to reduce costs, effective management of human resources is crucial to prevent staff burnout and errors caused by fatigue.

To cater for sudden increases in volumes of patients, ER Consulting Inc. has a second on-call system that gets activated. In addition, a senior telephonic advisory service assists with logistical support. In rare cases of extreme overload, other resources are mobilised from our deep doctor resource.

In medical practice, the most severely ill or injured patients are prioritised for treatment. This process of assessing a patient’s condition is known as triage, conducted promptly by a nurse upon arrival at the emergency unit. Triage categorises patients into one of 4 color-coded groups (Green, Yellow, Orange, Red), ranging from least to most severe urgency. Patients are then attended to in order of medical severity, with the most critical cases receiving immediate attention.

Triage can be frustrating for patients who may feel it places them lower in the queue. This is particularly evident if someone arrives after you but is triaged with a higher urgency colour. ER Consulting Inc. uses the triage system to prioritise patients based on medical need. To address wait times for less urgent cases, we are implementing several initiatives. These include testing the CareFirst system, enhancing laboratory and radiology turnaround times, and making ergonomic improvements to our facilities. 

The severity of the emergency dictates what to bring with you. If you feel that you have an emergency that is life or limb-threatening then do not hesitate, get to the emergency department as soon as possible. Anything left behind can always be retrieved later by a family member or friend. Patients should be reassured that no patient will ever be refused treatment for a life or limb-threatening injury while waiting for ANY details of ANY kind.

In an emergency, the hospital and the doctors will want to know the following:

    • Your name
    • Your ID
    • Your medical aid card
    • Your next of kin
    • Your usual doctor

If you think you may be admitted, an overnight bag with a change of clothes, underwear, gown and slippers, and toiletry bag should be more than enough.

The new Effortless ER System aims to eliminate the need to remember any of your demographic information and will reduce waiting times. Watch this space!

There are several types of billing codes. Billing codes can be for Hospital Services, Doctor Services and Stock and Consumables. In the emergency unit, you may come across all three code types.

Hospitals own emergency units. The hospitals generally provide the facility, equipment, nursing and administration in an emergency unit. The hospital will always charge you a “Facility Fee” when you use an emergency unit over and above the doctor’s fees.

The doctoring of the emergency facility is provided by an outsourced doctor group (ER Consulting Inc. being the largest in South Africa). Specialists who work in a hospital are not employed by the hospital either (this includes X-ray and Pathology Services). When you attend an emergency unit, therefore, you may receive several accounts from the different service providers.

Billing codes are standardised codes for various consultations and procedures performed by multiple service providers. Codes are useful for the funders (medical aids) to understand what is being claimed by the doctors accurately. Doctors and hospitals are guided as to what to charge for each code by various organisations, however, a doctor is allowed by right to choose his/her fee for any code.

The codes charged to you will appear on the account you receive from each service provider.

For more information on ER Consulting Inc.’s billing, click here. 

Emergencies are often overwhelming. This means that all your focus is on getting the care you need as quickly as possible. Often it is difficult in a crisis to pay attention to all the detail and information many people are giving you. You are also often concerned about your or your loved one’s condition, and therefore not listening to all the information you are given. Doctors and nurses also often use medical language that is not clear, and if they are busy, this often comes out fast.

Despite the confusing, overwhelming environment of the emergency department, it is vital that you understand everything that is being asked of you and done to you! Don’t be afraid to ask if you don’t understand. The doctors, nurses and administrators are required to give you all the information you need to make an informed decision.