Original Work Report Done

Original Work
Report
January 25, 2016
Tori Benson
toribenson6@gmail.com
http://goo.gl/forms/SEYtDFbYMj
Table of Contents
I.
Objective Summary ................................ 2
II. Methodology .......................................... 3

III. Demographics ........................................ 5
IV. The Survey ............................................. 7
V. Survey Results ........................................ 9
VI. Analysis and Purpose ........................... 17
Objective Summary
This year in ISM I am studying Primary Care Physician or more specifically Emergency
Medicine. On one of my interviews with an ER doctor, named Dr. Armstrong, we discussed
the disconnect between what the doctors and hospital feel constitutes an emergency and
what patients feel constitutes an emergency. Many come to the ER for things like headaches,
toothaches and joint pain that is not new, nor emergent, but has even maybe been persisting
for months. Dr. Armstrong expressed to me that his job is only made harder when people
are coming in with heart attacks or having over-dosed when he has to go see patients who
have had a knee ache for three months and spend valuable time in their room trying to get
them to give enough information to tell him what is actually wrong and how emergent it
really is.
This is how I got the idea for my original work project. I want to study the most common
reasons people go to the emergency room and cross reference that to the lists on hospital
websites that constitute an ER visit.
I also want to take that information and put it in a survey to see, if outside of the situation
itself, what the general public feels is an actual emergency, which they would go to the ER
for, and what isnt, and could be delegated to a family doctor or specialist. In the ER, the
doctors are required to treat the direst patients first and work their way down, so they have
to decide which cases are more important to treat first. Some of this comes down to opinion,
but each hospital has a protocol and this is what leads to the somewhat bad public view of
ERs because people hate waiting. However, if it was more common for people to
understand the way the ER system works and what an actual emergency is than that bad
view might change. That is the point of the survey; to see how informed people are on the
emergency room system and what actually constitutes an emergency. The survey will have a
combination of what the standard actually is for an emergency, what the most common
reasons for emergency visits are, and what the protocols are for such visits. I will take the
information from the survey and put together statistics on the public opinion. If I could I
would send the same survey to doctors in the area and add those statistics to the group but
doctors are hard to reach and rarely divulge opinions through such means. This information
would be beneficial not just for me but also for the general public when it comes to
awareness and also, in the long run, to hospitals; which get the brunt of public criticism for
the way they run emergency rooms.
Note: The complete survey questionnaire is included later in this document for reference.
ORIGINAL WORK REPORT - JANUARY 25, 2016
Methodology
For my Original Work I spoke with several of the physicians I interviewed and tried to
understand why exactly the public seems to have such a negative view of Emergency Rooms.
Once I compiled all their opinions and did some research on the number one
misconceptions about the ER I decided to ask the public what they thought and hear from
them what they think goes on in the ER to have a fully informed way of viewing this issue so
I could better try and address it, or raise awareness over it. My main passion was public
awareness and now that I have the information I can use it to shape my final product and
inform people where the disconnect occurs between hospitals and the general public so that
the ER does not continue to have a bad reputation for reasons that are illogical.
Questionnaire topics included:
Age
Gender
Having ever been to an ER, and if so why?
Would one go to the ER for a headache?
On a scale of 1-5 how emergent would one say a headache is
Which of the following is ER worthy: foreign objects in the body, skin infections, back
pain, cuts and contusions, toothaches, abdominal pain, chest pain, vomiting, and vehicle
accidents
How is patient care order decided in the ER?
What percentage of people leave the ER without being seen?
If one leaves the ER without being seen then is it a true emergency?
On a scale of 1-5 how effective is the ER system at providing the best possible care? If
less than 3, why?
These questions are all opinion based and are based on the most common reasons for
people to visit the ER and on how they think the ER truly operates. The problem with the
system is that it is all based on acuity, so some of those are things that you should go to the
ER for but not if it is not truly severe. This is why I wanted to see the public opinion versus
the physicians opinions. In order to do so I took what I knew and the research I had done
and started a survey on Google. Once I wrote and perfected the survey with the above
questions I sent it out to anyone and everyone I knew asking them to help me. Once people
started responding I asked Google to make me a spreadsheet of the responses and just
waited till I had a large enough response pool to start writing this report. I asked all my
friends and family to send out the survey as well and was able to get back thirty six responses.
Note: The results reported can only be considered the opinions of the survey participants.
They cannot be generalized to represent the entire general population as a whole.
Demographics
Survey responses are broken out by several demographic categories, as follows:
The percentage of respondents are broken out by:
Age 13 to 18
Age 19 to 25
Age 26 to 30
Age 30 to 40
Age 40 to 50
Ages 50 and above
Gender
If ever been to an ER or not
Most of my responses were from people ages 13-18 which isnt exactly what I had hoped for
but it did serve to give me a good idea of what the younger generations think about current
medical care.
Age and Gender

30
25
# of people
20
15
10
5
0
Female
Male
13-18
24
10
19-25
0
1
26-30
1
0
30-40
0
0
40-50
1
1
50+
0
0
Been to the ER or Not

18
16
14
# of people
12
10
8
6
4
2
0
Yes
No
Female
16
8
Male
6
6
The Survey
Emergency Care and Procedures
The survey I created was to get a sense of the communitys knowledge on the Emergency Room and how it
works and flows. I also asked some questions about the kinds of things people go to the ER for to see how
many of the most commonly seen reasons for ER visits are ones people outside of the situation itself would
go to the ER for.
Below is the survey itself
Survey Results
Number
Age
Gender
Ever been to
the ER?
13-18
Female
No
19-25
Male
No
13-18
Female
Yes
13-18
Male
Yes
13-18
Male
No
13-18
Female
Yes
13-18
Female
No
13-18
Female
Yes
13-18
Female
Yes
10
13-18
Male
Yes
11
13-18
Female
Yes
If so, why?
N/A
N/A
Asthma and
allergy attack
Broken hand,
busted head
N/A
Dizziness/Fainting,
trouble breathing
N/A
Broken wrist
Food poisoning,
allergic reaction
Head injury
Broken arm
Skin rash, asthma
attack
12
13-18
Female
Yes
13
13-18
Female
No
14
13-18
Female
Yes
15
13-18
Female
No
16
13-18
Female
Yes
17
13-18
Male
No
18
13-18
Female
Yes
19
13-18
Male
No
20
13-18
Female
No
N/A
21
13-18
Female
No
22
13-18
Female
Yes
N/A
Blurry vision,
possible
concussion
N/A
Fainted
N/A
Food poisoning
N/A
Broken arm
N/A
23
13-18
Male
Yes
24
13-18
Female
Yes
Nut allergy
reaction
Head injury with
vomiting
25
13-18
Female
No
N/A
26
13-18
Female
Yes
27
40-50
Female
Yes
28
13-18
Female
Yes
29
13-18
Male
Yes
Surgery
Broken bone,
kidney stone, UTI,
chest pain,
lacerations,
respiratory
distress,
abdominal pain,
food poisoning
Cracked open
chin
Broken arm and
thumb,
appendicitis
30
26-30
Female
Yes
Broken foot
31
13-18
Male
Yes
Cracked open
head
32
13-18
Female
No
33
13-18
Female
Yes
N/A
Respiratory
distress, lung
infection
34
40-50
Male
Yes
Chest pain
35
13-18
Male
No
N/A
36
13-18
Male
No
N/A
10
How
emerge
nt is a
headac
he Scale
of 1-5
Would you
go to the
ER for a
headache
Depends on
the severity
No
No
Depends on
the severity
No
Depends on
the severity
Depends on
the severity
No
No
Of the listed
symptoms which is
worthy of an ER
visit?
Foreign objects in the
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
Cuts and Contusions,
Chest Pain, Vehicle
Accidents
(3/9)
Skin infections,
Abdominal Pain,
Chest Pain, Vomiting,
Vehicle Accidents
(5/9)
body, Skin infections,
Abdominal Pain,
Vehicle Accidents
(7/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
body, Cuts and
Contusions,
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
body, Skin Infections,
Toothache, Cuts and
If you
leave the
ER without
being seen
was it a
true
emergenc
y?
How
effective
is the
current
ER
system?
Scale of
1-5
If less than
3, why?
No
N/A
No
N/A
No
N/A
No
N/A
No
N/A
Yes
N/A
No
N/A
No
N/A
No
N/A
11
10
No
11
Depends on
the severity
12
Depends on
the severity
13
Depends on
the severity
14
Depends on
the severity
15
Depends on
the severity
16
Depends on
the severity
17
Depends on
the severity
18
Depends on
severity
Contusions,
Abdominal Pain,
Vehicle Accidents
(8/9)
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(6/9)
Abdominal Pain,
Vehicle Accidents
(7/9)
Skin infections, Cuts
and Contusions,
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
Vehicle Accidents
(3/9)
body, Cuts and
Contusions, Chest
Pain, Vehicle
Accidents
(4/9)
Chest Pain, Vehicle
Accidents
(5/9)
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
body, Chest Pain,
Vehicle Accidents
(3/9)
body, Abdominal
Pain, Chest Pain,
No
N/A
Yes
No
N/A
They dont
pay
attention to
how crtical,
only care
about time
of arrival
No
N/A
No
N/A
Yes
N/A
No
N/A
No
No
N/A
Personal
bias on
who is
12
Vehicle Accidents
(4/9)
19
Depends on
severity
20
Depends on
severity
21
Depends on
severity
22
No
23
Depends on
severity
24
Depends on
severity
25
No

Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
Back pain, Cuts and
Contusions,
Abdominal Pain,
Vehicle Accidents
(8/9)
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)

body, Cuts and
Contusions,
Abdominal Pain,
Vehicle Accidents
(6/9)
Abdominal Pain,
Vehicle Accidents
(6/9)
treated,
long wait
times, ofen
not seen by
MD leading
to misdiagnosis
No
N/A
Yes
N/A
Yes
N/A
No
N/A
No
No
N/A
The people
who arent
being seen
sit feeling
worse
about
themselves
because
no one
talks to
them
No
N/A
13
26
Depends on
severity
27
No
28
Depends on
severity
29
Depends on
severity
30
Depends on
severity
31
Depends on
severity
32
Depends on
severity
33
No
34
Depends on
severity

body, Cuts and
Contusions,
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
body, Cuts and
Contusions,
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
Back pain,
Abdominal Pain,
Vehicle Accidents
(7/9)
body, Cuts and
Contusions, Chest
Pain, Vehicle
Accidents
(4/9)
body, Cuts and
Contusions,
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(5/9)
body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
Abdominal Pain,
Vehicle Accidents
No
N/A
No
N/A
No
N/A
No
N/A
No
N/A
Yes
N/A
No
N/A
No
N/A
No
N/A
14
(7/9)
35
No
36
Depends on
severity

body, Abdominal
Pain, Chest Pain,
Vehicle Accidents
(4/9)
Back pain,
Abdominal Pain,
Chest Pain, Vehicle
Accidents
(6/9)
No
N/A
No
N/A
15
16
Analysis and Purpose

First Im going to talk about the correct answers to the questions had that them.
Would you go to the ER for a headache?
o This question though somewhat based on opinion was more to gauge what
people thought about the subject outside of the situation itself. The correct
answer is Depends on the severity. Some headaches can be very painful and
even a symptom of further illness but one everyday headache on its own is not
enough to go to the ER for.
Would you go to the ER for a headache?

30
25
# of Resonses
20
15
10
0
Incorrect
Yes
0
No
11
Depends on severity
0
25
Correct
17
Of the below listed injuries/symptoms which would you consider worthy of an

ER visit? Options- Foreign objects in the body, Skin infections, Back pain, Cuts and
Contusions, Toothaches, Abdominal pain, Chest pain, Vomiting, Vehicle Accidents
o This question includes all of the most common reasons for people to visit the
ER. Now under the right circumstances many of these are justifiable reasons
for visiting the ER such as: foreign objects in the body, skin infections, cuts
that may need stitching, abdominal pain if severe enough for fear of
appendicitis, chest pain because it can be the signal for a heart attack, vomiting
if overly excessive and vehicular accidents that lead to excessive bodily harm.
Even some of these however could be delegated to a family doctor or clinic
on the grounds that the ER has to function by taking the worst case first.
Of the below listed injuries/symptoms which would

you consider worthy of an ER visit?
40
# of people who selected
35
30
25
20
15
10
5
0
Foreign
Skin
Objects
Infectio
in the
ns
Body
Incorrect
0
0
Correct
33
16
Back
Pain
Cuts/Co Toothac Abdomi

ntusions
hes
nal Pain
Chest
Pain
Vehicle
Vomitin
Acciden
g
ts
16
30
35
36
18
Which is the way in which patient care order is decided in the ER?
o Patient care order is decided based on acuity, or how critical ones condition is.
It is under no circumstance based on time of arrival which for those with
minor injuries or less critical symptoms can amount to a long wait time.
Which is the way in which patient care order

is decided in the ER?
35
30
25
20
15
10
5
0
Incorrect
There is no
Procedure
1
Correct
29
By time of Arrival
Based on Acuity
Based on Age
19
What percentage of people do you think leave the ER without even being
seen? This could be out of frustration or otherwise
o This number really varies based on the hospital, but the average for hospitals
in Dallas and at Childrens specifically is between 10-20%. Between 10-20%
show up to the ER and leave it without seeing a doctor. That percentage may
seem small but when it comes to peoples well-being it is most assuredly too
big. One way to shrink this percentage is to try and educate the public on what
is a good enough reason to actually make a trip to the ER and what is
something you can just treat with some Ibuprofen.
What percentage of people do you think leave the ER

without even being seen?
16
14
12
10
8
6
4
2
0
Incorrect
Correct
10-20%
0
30-40%
14
50%
4
60% and above

4
14
20
If they leave the ER without being seen do you think it's a true emergency?
o This question is also more opinion based but looking at it objectively if
someone leaves the ER without being seen then their reason for being there
was not strong enough to make them really want to stay. Some people come
into the ER for anything and everything and once frustrated walk out without
even receiving care, this is a good example of the misuse of ERs that has led
to the downfall of some hospitals reputations as well as the decline in the
publics faith in the fact that they are getting the best possible care.
If they leave the ER without being seen do

you think it's a true emergency?
35
# of people selected
30
25
20
15
10
5
0
Incorrect
Correct
Yes
6
No
0
30
21
Now for the questions that dont have a set answer and were more about opinion and what
the public thinks about certain subjects.
How emergent would you say having a headache is? Scale of 1-5
o This question is entirely opinion based and was added to the survey to try and
see how many people when removed from the pain of the situation would say
a headache is a real emergency.
How emergent would you say having a

headache is? Scale of 1-5
25
# of responses
20
15
10
0
Responses
1
9
2
20
3
6
4
1
5
0
22
How effective do you feel the current ER system is in providing the best
possible care? Scale of 1-5
o This the last question and it is also entirely opinion based for the purposes of
gauging how people view the ER and why they view it that way.
How effective do you feel the current ER

system is in providing the best possible
care? Scale of 1-5
25
# of responses
20
15
10
0
Responses
1
0
2
3
3
22
4
11
5
0
23
Each of these questions served a purpose in showing me the publics opinions

and if the way they saw the ER is the way it really works. What this survey proved to
me is that in most instances the misconceptions, as I thought they were, are not
misconceptions at all. People more often than not know the correct answer to all of
the protocol questions so that cant be the reason the ER is viewed the way it is.
Almost 81% of people knew that the ER runs based on how critical the condition of
patients is and yet the most common complaint when it comes to the ER is wait
times. What this has proved to me is that it all comes down to human nature. When
removed from a situation and asked how one views the ER people have nothing bad
to say and can logically process how the system works, but when in the heat of a
crisis, or what some think is a crisis, the impatience and the entitlement start to shine
through and it becomes hard to be logical. It can be hard to fix a problem that isnt
based in lack of knowledge but in re-wiring the way people react in certain situations.
That needs to be the next step, where people look to go next when trying to better
the opinion on healthcare.
24

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Original Work

Objective Summary ................................ 2

II. Methodology .......................................... 3

ORIGINAL WORK REPORT - JANUARY 25, 2016

Age and Gender

ORIGINAL WORK REPORT - JANUARY 25, 2016

Been to the ER or Not

ORIGINAL WORK REPORT - JANUARY 25, 2016

Below is the survey itself

ORIGINAL WORK REPORT - JANUARY 25, 2016

ORIGINAL WORK REPORT - JANUARY 25, 2016

ORIGINAL WORK REPORT - JANUARY 25, 2016

ORIGINAL WORK REPORT - JANUARY 25, 2016

ORIGINAL WORK REPORT - JANUARY 25, 2016

ORIGINAL WORK REPORT - JANUARY 25, 2016

Foreign objects in the

Foreign objects in the

ORIGINAL WORK REPORT - JANUARY 25, 2016

Foreign objects in the

ORIGINAL WORK REPORT - JANUARY 25, 2016

Foreign objects in the

ORIGINAL WORK REPORT - JANUARY 25, 2016

ORIGINAL WORK REPORT - JANUARY 25, 2016

Analysis and Purpose

Would you go to the ER for a headache?

ORIGINAL WORK REPORT - JANUARY 25, 2016

Of the below listed injuries/symptoms which would you consider worthy of an

Of the below listed injuries/symptoms which would

# of people who selected

ORIGINAL WORK REPORT - JANUARY 25, 2016

Cuts/Co Toothac Abdomi

Which is the way in which patient care order

# of people who selected

ORIGINAL WORK REPORT - JANUARY 25, 2016

What percentage of people do you think leave the ER

# of people who selected

60% and above

ORIGINAL WORK REPORT - JANUARY 25, 2016

If they leave the ER without being seen do

ORIGINAL WORK REPORT - JANUARY 25, 2016

How emergent would you say having a

ORIGINAL WORK REPORT - JANUARY 25, 2016

How effective do you feel the current ER

ORIGINAL WORK REPORT - JANUARY 25, 2016

Each of these questions served a purpose in showing me the publics opinions

ORIGINAL WORK REPORT - JANUARY 25, 2016

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