Rough Draft Qualitative Research Critique and Ethical Considerations
The critical evaluation of two qualitative research studies that follow is based on the PICOT question about how a fast-track system in emergency rooms helps to reduce overcrowding, which in turn reduces patient wait time. “A systematic review of triage-related interventions to improve patient flow in emergency departments” by Oredsson et al. and “Effect of an Emergency Department Fast Track on Press-Ganey Patient Satisfaction Scores” by Hwang et al. were chosen for critical appraisal.
Study Background
According to the article by Oredsson et al., overcrowding in the emergency department is a growing global problem. It is worth noting that overcrowding has a negative impact on patient safety, privacy, and the time it takes for medical practitioners to attend to patients. The proposed solutions to overcrowding primarily emphasize workflow orientation. However, there is the insufficient scientific knowledge to improve the workflow, so no clear strategy for providing the best solution exists. The majority of countries have implemented healthcare standards with the goal of reducing the length of stay in the emergency department. The goal of this study is to discover scientific evidence that improves patient flow in the emergency department (Oredsson et al., 2011).
According to the article by Hwang et al., the Centers for Medicare and Medicaid Services implemented a new hospital payment system. There is a problem with patient satisfaction when it comes to value-based purchasing of healthcare services. As a result, implementing fast-track in the emergency department has the potential to improve both provider and patient satisfaction. The proposed goal of this study is to investigate whether the implementation of a fast-track system in the emergency department has the potential to affect the Press-Ganey scores in terms of patient satisfaction (Hwang et al., 2015).
How do these two articles relate to the nurse practice issue you selected?
Based on the objectives of the two articles, the two articles attempt to provide solutions to the problem of emergency department overcrowding. Furthermore, the strategies proposed in the aforementioned articles have a time frame for the intervention suggested in both. According to the article by Oredsson et al., the emergency room fast-track intervention was the most effective in improving patient flow and subsequent patient satisfaction. Furthermore, incorporating a team triage in providing care increases efficiency and accuracy, which has the effect of reducing the length of stay. The fast-track strategy, on the other hand, is ideal for patients with less serious symptoms. The use of both team triage and a fast-track system reduces the number of patients who leave without receiving medical attention significantly (Oredsson et al., 2011). The case of overcrowding in the hospital’s emergency department is solved in the article by Hwang et al. through a fast-track intervention through the enhancement of various metrics related to healthcare providers and patients. This is practically accomplished by having designations within the emergency department to ensure that patients are seen as soon as possible. Improvements in the seven dimensions of the Press-Ganey patient satisfaction metrics have resulted from the incorporation of these designated areas (Hwang et al., 2015). As a result, the intervention occurs in a timely manner, similar to the PICOT question, where the overall length of stay in the emergency department is significantly reduced.
Research Methodology
The methodology used in the article by Oredsson et al. is a systematic literature search focused on studies on flow processes in hospital emergency departments. Following the search, the results were refined using inclusion and exclusion criteria. As a result, results were excluded if they lacked relevant data on waiting time, length of stay, and patients who left without receiving medical attention (Oredsson et al., 2011). The presence of a control group in search results was an important inclusion criterion in the study. The systematic literature search had the advantage of producing more reliable results than a single study. The selection and publication bias is a disadvantages of this method. In the Hwang et al. article, an analysis of patient-submitted Press-Ganey questionnaires was performed, which was based on a cross-sectional study. The survey’s main focus was on patient satisfaction metrics in order to determine the experience during care in the emergency department (Hwang et al., 2015). The questionnaire method has the advantage of being a quick and inexpensive way of obtaining results on the issue of overcrowding and patient satisfaction in the emergency department. However, one disadvantage of this method is its unreliability and difficulty in interpreting feedback.
The Study’s Findings
Following an analysis of 140 respondents prior to the emergency department, Hwang et al. fast-tracked 85 respondents in their article. The response rate in this regard was 14.8%. The results revealed that the addition of fast-track designated areas in the emergency department resulted in a significant improvement in patient satisfaction metrics. It is worth noting that overall patient satisfaction increased from 68% to 88%. (Hwang et al., 2015). In the article by Oredsson et al., the studies that met the inclusion criteria were classified as streaming, fast track, team triage, point of care, and nurse x-ray. There were 33 studies that met the inclusion criteria, with over 800,000 patients. According to the findings, the implementation of a fast track in the emergency department resulted in a reduction in waiting for time and length of hospital stay. However, the impact of team triage on patients leaving without medical attention was relatively strong (Oredsson et al., 2011).
Considerations for Ethical Behavior
When conducting research, ethical considerations are important because they ensure that the researcher follows acceptable practices. Respect for the dignity of research participants is an example of ethical consideration. As a result, it is critical to protect one’s privacy and overall treatment during the research process. Furthermore, when conducting research, it is critical to ensure that all research participants have given their full consent to participate without any form of coercion. In order to obtain the results of most research studies, the authors must declare that they followed ethical practices when conducting the research. For example, in the study by Hwang et al., ethical considerations were upheld in the administration of the questionnaire by maintaining participant confidentiality. Furthermore, the intervention was carried out in a way that did not jeopardize the patient’s ability to receive healthcare.
References
Hwang, C. E., Lipman, G. S., & Kane, M. (2015). Effect of an emergency department fast track on Press-Ganey patient satisfaction scores. Western Journal of Emergency Medicine, 16(1), 34.
Oredsson, S., Jonsson, H., Rognes, J., Lind, L., Göransson, K. E., Ehrenberg, A., … & Farrohknia, N. (2011). A systematic review of triage-related interventions to improve patient flow in emergency departments. Scandinavian journal of trauma, resuscitation and emergency medicine, 19(1), 43.
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Question 
Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1”(LOCATED IN ATTACHMENTS) document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the studies in your responses.
Rough Draft Qualitative Research Critique and Ethical Considerations
Use the practice problem and two qualitative, peer-reviewed research articles you identified in the Topic 1 assignment(LOCATED IN ATTACHMENTS) to complete this assignment.
In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.