Increasing Visits to Accident and Emergency Departments in Public Hospitals
Student’s Name
Instructor’s Name
Institutional Affiliation
Cours
Date
Introduction
The government of Hong Kong is putting forward a proposal to increase the visit fees of Accident and Emergency Departments(AED) in the public hospitals with the purpose of combating the practice of people who constantly make use of these facilities to seek medical attention although their matters are not urgent. However, knowing the current situation and evaluation of AED utilization in a city is crucial before those measures are enforced. The Statistics show that non urgent cases are filling up in AEDs, it pose challenges to the proper functionalities of Emergency Healthcare services which is what the healthcare sector deals with. The aim of this essay is to investigate the trends and cultural component that enables this state go affairs by delving into the reasons why individuals prefer AEDs as treatment for minor health issues. Also, this alternative strategies rather than fee rises will be examined with a mind of impactfulness, including component of public education campaigns, improvement of primary care sector and establishment of powerful triage systems.
Understanding the Current Culture of Accident and Emergency Usage
The culture of the AED use is a result of a complicated interaction between the cultural norms, accessibility of healthcare, as well as perception of the individual about healthcare services. Statistics reveal a notable trend: underlying 40% of the visits to AED admissions in the hospitals of the public sector is constituted of non-urgent cases which evidently reflects a huge load on emergency healthcare. This pattern may be partly due to citizens of Hong Kong believing that AEDs are generally accessible and give immediate first avail and comprehensive medical help without considering what the patient problem is(Stratman et al., 2023). This notion is built upon a historical inclination for hospitals to be a primary port of healthcare, which has been strengthened by the fast but over-flooded nature of AED-system. In addition, the cultural stresses including the emergency treatment for even minor health conditions and being turned down from healthcare service providers due to inability to pay the bills push more people towards AEDs for self-medication(Yearby, 2018).
Additionally, the low understanding and accessibility of the alternative healthcare modes will only serve to push the use of AEDs even further. A large number of Hong Kong people may not have heard ever about the primary care or have the idea that facilities for the primary care are worse than those of the emergency departments. Owing to this no understanding and few primary care doctor meetings, affordable healthcare will jostle AED to be their default healthcare provider. Additionally, the factor of convenience, in turn, contributes greatly to the increased demand for AED usage; otherwise, emergency departments are often considered to be more convenient and patient-oriented compared to primary care providers which are sometimes exposed to lengthy wait times and thus available appointments are restricted (Fraess-Phillips, 2021).
Cultural acceptance of the fact of falling a victim to an illness and the behavior in seeking emergency medical care in fact contributes greatly to the scenario of AED usage in Hong Kong. Typical Chinese system of health and healthfulness, like instant treatment and herbal remedies use, may provoke some people to go into an emergency department rather than alternative primary care services(Wangkheirakpam, 2018). Similarly, fears about personal health of a certain disease and others might not be keen to share their symptoms, which can portray other people to opt for the privacy and security that online plan cure offers them.Moreover, incentive structure and financial resource allocation in the healthcare system in Hong Kong are the factors responsible for today’s culture of AED use. High rates of closures of primary care practices during the business hours and over the weekends force patients to depend entirely on the walking-in-type of attention from same-day emergency departments to receive primary care fast. Also, a near absence of workable triage systems in AEDs could lead to patients whose condition is not so serious to be attended to paramount to those with critical emergencies thus aggravating the waiting time as well as the overcrowding.
Suggested Strategies to Remedy the Situation
In order to reduce the overburdening of Emergency & Accident Departments (AEDs) in Hong Kong, a couple of measures could be introduced as part of a broader strategy to deal with shortages in AEDs and make the healthcare system in the city more efficient. Ultimately, the most crucial initial step is to begin crafting strategic public education campaigns that can draw people’s attention to appropriate healthcare practices, while also communicating the alternatives ways in which to access care. By using this approach, the campaigns should highlight the fact that emergency and non-emergency health situations are two different things. People should be taught the right time to visit AEDs and when it is advisable to see inpatient clinics or outpatient physicians. These campaigns have the potential to engage the individuals and thus creates informed decision making about their healthcare utilization. This in turn enhances the services offered by AEDs while improves the avenue of health services resources.
The addition to the primary care services as the second pillar of the education goes along with the directed non-urgent cases away from AEDs. This can be done by widening up the scope of their operations during evening and weekend hours so as to cope with the unique demand when they are highly accessed. Moreover, widening the range of services provided by primary healthcare to encompass minor acute services is capable of supplying with an available the alternative of AEDs to people in their pursuit of health service they need. On the other hand ,telemedicine services could be used in order to run virtual consultations of not urgent cases which would help cutting down those unneeded visits to the emergency rooms.Ensuring that AEDs have robust triage systems so as to direct patients to the equipment primarily with consideration of their level of illness is of great importance. Triage systems help optimize the workflow of ED by helping to appropriately sort patients basedon their signs and thereafter direct those with less critical conditions to appropriate alternative care setting this helps to lessen the wait time for patients with serious medical emergencies(Nates & Sprung, 2020). Additionally among making financial in-puts for training and all resources for the triage department manages to categorize the flow of patients depending on their medical needs.
Effectiveness of these Strategies
The feasibility of the policies that aim to correct the increased demand to the Accidental & Emergency Departments (AEDs) in Hong Kong will depend greatly on their ability to respond to behaviors on the individual level and on the wider aspects of the healthcare system. Public education programs also have demonstrated their effectiveness in other regions of the world that have seen a decrease in inappropriate AED usage due to greater knowledge about accessing healthcare when there is non-emergent need for medical care. Creating awareness through campaigns on the difference between emergency and non-emergency medical needs is necessary for these campaigns to help people make the right decisions regarding their healthcare utilization. When the misuse of such resources is reduced, the AED system works effectively and efficiently.
Helpful steps to follow after have shown that another critical strategy for reducing the burden on emergency departments are enhancing primary care facilities. Through better accessibility to the primary care providers and a wider scope of the offered services, a big number of people are supplied with non-AED type of solutions for their problems within a health system. Moreover, telemedicine services are also able to expand the scope of primary care, especially cases which do not require certain level of dimensions, through online consultation and halting of physical office visit to emergency departments.
In addition, setting strong triage systems at the outset of all AEDs is vital to guarantee an even distribution of resources as well as prompt care to those patients based on the severity of their conditions. With efficient patient assessment, through triage systems and subsequent referral of non-urgent cases to suitable alternative healthcare facilities, such triage systems are intended to be the stepping-up system of emergency services of healthcare delivery and the reduction of wait times for critical cases. The situational success of the triage systems is dependent on the fact of staff training and resources sufficiently allocated for this instrumentation.
These approaches have given hope to a way of countering the overuse of AEDs in Hong Kong, but they are in themselves limited sources of solutions taking into account a number of contextual factors that affect the effectiveness rate of the implemented measures, among them cultural attitudes towards healthcare, resource availability and the capacity of the system. Pursuing continual evaluation and modifications of these policies will be inevitably important in keeping healthcare up-to-date and maximizing In this regard, partnership between healthcare providers, policymakers, and state representatives will be a sine qua non for an acceptable implementation and further development of such strategies. Such system is sure to be efficient and fair and, of course, can deal with the whole set of challenges and problems facing it with the help of a multifaceted approach that targets individual habits and current issues connected with the healthcare system in Hong Kong.
Conclusion
In summary, designing a comprehensive solution to the high usage of AEDs in Hong Kong means multifaceted strategies, such as conducting public education, improvement in primary healthcare facilities, and the setting of tougher triage systems. Even though these approaches open new way to mitigate the emergency department’s burden, their application relies heavily on the continuous checking, adjustment, and coordination between the providers across the stakeholders. Sustainable interventions that tackle the individual actions and the underlying structures in the healthcare system can foster a responsive healthcare system that is fair to all and that gives prompt emergency treatment to those who really need it and encourages responsible use of medical services.
References
Fraess-Phillips, A. (2021). The effects of primary care accessibility and continuity of care on less-urgent emergency department use. https://doi.org/10.24124/2021/59155
Nates, J. L., & Sprung, C. L. (2020). Emergency medicine and critical care triage. In Springer eBooks (pp. 77–88). https://doi.org/10.1007/978-3-030-43127-3_8
Stratman, E. G., Boutilier, J. J., & Albert, L. A. (2023). Uncertainty in facility location models for emergency medical services. In International series in management science/operations research/International series in operations research & management science (pp. 213–250). https://doi.org/10.1007/978-3-031-32338-6_9
Wangkheirakpam, S. D. (2018). Traditional and folk medicine as a target for drug discovery. In Elsevier eBooks (pp. 29–56). https://doi.org/10.1016/b978-0-08-102081-4.00002-2
Yearby, R. (2018). Racial disparities in health status and access to healthcare: The continuation of inequality in the United States due to structural racism. American Journal of Economics and Sociology/the American Journal of Economics and Sociology, 77(3–4), 1113–1152. https://doi.org/10.1111/ajes.12230
Part B:
Advanced Care Planning
Introduction
Advance Care Planning (ACP) and Advance Directives (AD) adoption by healthcare facilities have received a lot of attention worldwide gathering all efforts under one aim to protect the autonomy of patients especially at dying stages and to respect their wishes regarding the end of life care. On the other hand, the Hospital Authority (HA) has been leading by an example, in that it has identified the right of its clients to the ADs in clinical care. Nonetheless, ADs may be tensed for healthcare workers by the guidelines where one of the customers loses his capacity for decision making. This act has thus been a subject of ethical discussions as this is another way of breaking the very purpose of ancestry DNA tests. This essay will delve into the global landscape of ACP and AD practices, analyze their ethical implications, and discuss the suitability of the current approach within the context of healthcare in Hong Kong.
Global Perspectives on Advance Care Planning and Advance Directives
Across the world, Advance Care Planning (ACP) and Advance Directives (AD) are seen as the cornerstone of end-of-life care that shows that nowadays it is increasingly accepted that people have a legitimate right to determine the way they want to die and how they want to be taken care of at the end of life. In the USA, Canada and some parts of Europe ADS, which are usually legally binding agreements between individuals and doctors that allow patients to set advanced medical treatment plans amidst the loss of medical decision capabilities, are regarded as an important document(Dixon, 2018). These documents are being used as the mechanism by which patients may regain control of their health care choices and, even greater, their wishes are realized if they would be incapacitated of expressing them at the time of treatment. In addition, the fact remains various countries have a different level of registration and implementation of ADs which allows more rigorous laws that support automation to develop than in other countries. Despite these variations, the overarching goal of ACP and ADs remains consistent: to enable patients to make well-informed choices regarding their end-of-life care plan and educated health care professionals who can continue to support and guide patients in choices that align with their values and preferences. The global situation regarding ACP and ART displays a sense of partnership, which is geared toward patient centeredness and the application of autonomy and dignity as tools for improving the quality of life at the end of life.
Ethical Analysis
From a moral viewpoint, the implementing of Advance Care Planning (ACP) together with Advance Directives (AD) are rather difficult since patient’s autonomy should be allowed, they should be given benefit, nonmaleficence, and justice. To begin with, decentralization upon the decorated speech of the patients, be it Advance Directives, is the essential principle of autonomy to self-determination and the philosophy that their healthcare preferences will always be upheld even in case where they are unable to express them. It means that the medical decision making is based on values and wishes of a particular patient which is the primary ethical principle(Vakey, 2020).
On the other hand, the implementation of any agreement of decision when a patient becomes inresponsible may or may not favor the two parties involved. On one hand, clinicians could express the either-or situation where in order to protect and promote the clients’ interests , they at times work contrary to the ADs. This point of view is closely related to the doctor’s practice of beneficence and non-maleficence, when he carefully monitors the patient’s progress and minimizes additional weaknesses.
On the other hand can present arguments that making mandatory ADs will jeopardize patients’ independence and the whole system of healthcare. Respecting trespassing the authority of the healthcare professionals to diagnose and treat patients spurs doubts on transparency, accountability and fairness, thus contradicting the principles of justice and healthcare ethical behavior.
The healthcare practitioners ought to apply an acute sense of clinical judgment exercising their clinical skills and at the same time respecting patients’ autonomy as there is an increasingly higher number of complex cases. A best practice and mainly by the ethics of transparency and communication between patients, relatives and health care providers is essential for patients when it come to reaching agreement on end-of-life care decision and make sure that all involved stakeholders agree on the values and preferences towards the end of life.
Pros and Cons of Current Practice in Hong Kong
The current approach in Hong Kong in that the healthcare professionals could simply discard the Advance Directives (ADs) when patients cannot envisage decision-making.
Pros:
Clinical Flexibility: Pausing the effect of ADs eliminates the need for a rigid protocol that restricts adjustments and allows medical professionals to exercise clinical judgment aimed at the benefit of the patients. This flexibility is crucial for more individualized and adaptive care so that, in addition to cases in which wishes of the patient previously come into question or lead to adverse outcomes, this type of care can be administered.
Prevention of Harm: When ADs would be contravened thus causing distress or harm, or when adherence to ADs is against the patient’s best interests, then they ought to be suspended. Doing so could avert the un-necessary suffering, and would ensure that the patients will receive appropriate care. Healthcare professionals could continue as the drivers of patient well-being and carry out the decisions that would optimize the outcomes of the patients from their clinical judgment.
Cons:
Undermining Autonomy: Regarding the case with ADs validity suspension, it can be argued as this step would probably impair patients’ autonomy and, therefore, diminishes their integrity (Rejnö et al., 2019). Subjects may experience a lack of trust in the healthcare system as well as powerlessness because care preferences of such people may not be honored if they cannot speak for themselves.
Transparency and Accountability Concerns: There are questions about who really decides about AD suspensions when the transparency and accountability are not present in such decision-making. The subjective nature of clinical judgment on the part of health care providers may lead to the chaotic discussion of the health care system; however, it may enhance the trust for all participants taking part in the decision making processes.
The current policy targets prescription drug misuse and carries both clinical flexibility and aims to avoid harm at the same time, it brings significant ethical issues at the table that deal with patient autonomy, transparency, and accountability. Finding the balance among these factors is a prerequisite to providing the terminally ill with the care that is in line with the their values and preferences but at the same time promotes well being and dignity.
Conclusion
To summarize, ADs in Hong Kong have earned a new grey ethical area due to the controversial policy that now requires them to be revoked upon patient incapacity. An ethical question arises when this technology is deployed for clinical judgment, since it may cause harm rather than help. privacy, transparency and accountability are all blurred. The matter of whether the most relevant wishes of patients need to be honored or only their prior therapists’ judgment should be exercised should now be carefully examined. Ideally, the transparency and communication should be first priority to maintain shared decision-making at all times and to ensure that the patients’ values and preferences remain the forefront when facing a difficult end-of-life care situation and protecting their dignity.
References
Dixon, J., Karagiannidou, M., & Knapp, M. (2018). The Effectiveness of Advance Care Planning in Improving End-of-Life Outcomes for People with Dementia and their carers: A Systematic review and critical discussion. Journal of Pain and Symptom Management, 55(1), 132-150.e1. https://doi.org/10.1016/j.jpainsymman.2017.04.009
Rejnö, Å., Ternestedt, B., Nordenfelt, L., Silfverberg, G., & Godskesen, T. (2019). Dignity at stake: Caring for persons with impaired autonomy. Nursing Ethics, 27(1), 104–115. https://doi.org/10.1177/0969733019845128
Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119