HA599 Unit 5 Arrival Point Feasibility Analysis Example

Four Stretchers, If the Fire Marshal Agrees: A Capstone Feasibility Analysis Testing a Nurse-Staffed Arrival Area for Ambulance Patients at Tessford, a Composite Hospital, Against Space, People, Systems, Law and Politics, and Rating Each With Its Conditions

[Student Name]

Purdue University Global

HA599: Master's Capstone in Health Care Administration

Unit 5 Feasibility Analysis

[Instructor Name]

[Date]

The hospital, the county and every figure are composite and bracketed for the writer's own data; the regulation and guidance cited are real, and the analysis claims nothing about compliance.

The Proposal Being Tested

An arrival area run by a registered nurse from [12:00] to [00:00], in a [22]-by-[11]-foot alcove next to the ambulance doors that can take [four] stretchers at once. The nurse accepts report, signs for the patient, completes a rapid assessment and moves patients to beds or triage as space opens.

Feasibility Table

Space. Evidence: the alcove measures [22] by [11] feet; two supply carts now stand there. Rating: conditional. Conditions: the fire marshal confirms that the corridor keeps its required exit width with stretchers in the alcove; the carts move to a storeroom [40] feet away; a ceiling-mounted monitor bracket and two oxygen outlets are installed. Staffing. Evidence: the department carries a [14] percent registered nurse vacancy rate. Rating: conditional. Conditions: the float pool covers the role for the first [three] months while one position is posted; the role is never pulled to cover the floor, which the risk register will monitor. Information systems. Evidence: the record system can log a badge tap at the ambulance door, creating a time stamp that matches the county's arrival time. Rating: feasible. Condition: the build waits until an upgrade freeze lifts in week [six]. Legal and regulatory. Rating: feasible, with care. Discussion below. Organizational support. Evidence: the emergency department director and chief nursing officer support a pilot; the county EMS medical director has offered to change crew protocols; emergency nurses are split, with some fearing the role will be pulled; finance awaits the Unit 6 analysis. Rating: conditional on finance and on a staffing protection nurses can see. Only one of five rows is feasible without conditions, and that is normal for a real project; the conditions become the first tasks.

Staffing in More Detail

The role needs one registered nurse for twelve hours a day, about [4,380] hours a year, or roughly [2.1] full-time equivalents once vacation and education time are covered. The float pool has [11] nurses with emergency experience and confirmed that it can cover the role on [five] of seven days for three months, with the emergency department covering the remaining shifts through voluntary extra shifts at the standard rate. The posted position will be advertised as a defined role with set hours, which recruiters believe will attract applicants who want predictable evening work. The main staffing risk is not filling the role but protecting it: on busy nights, charge nurses will be tempted to pull the arrival nurse to a bedside, which would quietly end the pilot.

Systems in More Detail

A badge reader at the ambulance door records each arrival; the crew taps a county-issued badge, and the record links the time to the patient once registered. Informatics estimates [40] hours of build and testing.

The Legal Row in Detail

Under the federal emergency screening law, a hospital's duties apply to individuals who come to its emergency department, which includes arriving on hospital property by ambulance, and federal guidance applies those duties to patients brought in by EMS even while they remain on the ambulance stretcher (42 C.F.R. § 489.24, 2024). CMS has issued guidance criticizing the practice of keeping patients on EMS stretchers to delay the hospital's acceptance of responsibility, sometimes called parking (Centers for Medicare & Medicaid Services, 2006). A staffed arrival point accepts patients promptly and records the time, which reduces an existing exposure rather than creating a new one. This analysis does not claim that the hospital is or will be in compliance; only regulators make that determination. The legal department will review the arrival point's written process before opening.

Safety Feasibility

A hazard analysis of offload zones in Canada identified [78] failure modes, [28] of them high risk, including missed deterioration while waiting, unclear accountability and poor communication between crews and nurses (Carter et al., 2015). The design responds: the arrival nurse holds clear accountability from signature; patients with abnormal vital signs bypass the alcove; and vital signs are repeated every [30] minutes while a patient waits there.

What Would Make It Infeasible

A fire marshal ruling against the alcove, with no alternative space; or a staffing crisis that leaves no float coverage. Either would pause the project. An alternative space, a converted triage room, has been identified but is smaller.

Who Was Consulted

The facilities director walked the alcove; the float pool manager confirmed coverage; the informatics lead confirmed the badge build; the county EMS medical director reviewed the crew protocol; and [six] emergency nurses gave their views in a staff meeting.

Conclusion

The arrival point is feasible on conditions that are specific and achievable. Space and staffing conditions come first and set the timeline in Unit 7.

References

Carter, A. J., Gould, J. B., Vanberkel, P., Jensen, J. L., Cook, J., Carrigan, S., Wheatley, M. R., & Travers, A. H. (2015). Offload zones to mitigate emergency medical services (EMS) offload delay in the emergency department: A process map and hazard analysis. CJEM, 17(6), 670-678. https://doi.org/10.1017/cem.2015.15

Centers for Medicare & Medicaid Services. (2006). EMTALA: "Parking" of emergency medical service patients in hospitals (S&C-06-21).

42 C.F.R. § 489.24 (2024). https://www.ecfr.gov/current/title-42/section-489.24