This is not a problem with the 4 hour limit. The 4 hour limit means that
unless you are discharging the patient you need to get them to a bed within
4 hours (and 'bed' is further defined, but basically somewhere that is
reasonable comfortable and with a modicum of privacy). There is nothing in
this to stop patients from being moved to a more comfortable and private
area as soon as it becomes apparent that a decision to discharge cannot be
made within 4 hours; but still staying under the care of E.
--> Except not many places have large enough ward-like areas and those that
do have often got them filled by the elderly who are awaiting complicated
discharegs or by medical/surgical patients.
--> The main problem with the 4-hour limit is that it tends generically to
make SOME people do SOME things SOME of the time which are guided by how
long it has been since the patient booked in and NOT by what they really
think they want to do for the patient. It also makes SOME people bully and
trouble shop-floor workers because they themselves are treated likewise by
their managers who are all concerned about their chances for foundation
status and how 4-hour performance affects that...
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