A thesis statement is one of the most important elements of any successful essay. A thesis statement controls the subject matter of the essay and states something significant to the reader. It is the one statement that summarizes the main point of the essay and states why the essay is important and worth reading. An essay that lacks a strong thesis will be inadequate and often lacking in focus.
The following are qualities of a well-crafted thesis statement:
- A thesis statement should identify a specific purpose, a specific way to accomplish the purpose, and oftentimes a specific audience (depending on the type of essay).
- A thesis statement should assert something about the essay.
- A thesis statement should be easily identifiable by a reader and should be clear and not ambiguous.
- A thesis statement generally comes toward the end of the introduction.
Examples of thesis statements:
"In order to succeed in the classroom, college students need to utilize the resources available to them throughout their academic careers." Notice how this thesis statement includes a specific audience (college students), a specific purpose (success in the classroom) and the specific way this can be accomplished (utilizing available resources).
"The United States government needs to implement a nationalized healthcare system to lower the cost of healthcare and improve the overall health of all citizens." Notice how, much like the above example, this thesis statement also has a specific purpose (lowering the cost of healthcare and improving health) and a specific way to do so (implementing national healthcare). What this thesis does not address, because of the nature of the essay and topic, is a specific audience. A thesis statement for an argument essay does not always address a specific audience since it is written to broader audience with the attempt to persuade others to a specific viewpoint.
Just as the contents of the essay may change during the writing process, so, too, may the thesis statement. It is important to create a thesis statement before writing the paper, but this type of thesis is generally referred to as a working thesis and may change along with the contents of the essay. It is important that a writer uses the thesis to direct the creation of the essay, but it is also important that the writer is open to changing the thesis as necessary.
A reader should be able to easily identify the thesis in any essay. If someone reads your essay and cannot identify where the thesis statement is located, take this as a sign that the thesis is not clear and/or is not as specific or strong as it can be. Make sure that the thesis stands out and can be easily interpreted.
For more information on writing an effective thesis statement, please see the thesis statement exercise.
We will identify a subset of ESI 3 patients that will be affected by this strategy. This subset will include patients (1) whose chief complaint is any of the following: abdominal pain, vaginal bleeding, pregnancy complication, vomiting, flank pain, or headache; (2) those who meet predefined criteria; and (3) those who arrive to the emergency department (ED) Monday through Friday between 4 p.m. and 11 p.m.
We plan a two-step process for expediting care for ESI 3 patients. The first step is to add a physician to triage Monday through Friday between 4 p.m. and midnight (stretch will be extra hours and 7 days if possible). The subset of ESI 3 triaged patients will be referred directly to the physician in triage who will begin the evaluation of the patient and order appropriate tests. The second step is to utilize the ambulatory surgery unit (ASU) (which is one floor above the ED) as the ESI 3 patient district (mid-track). Here a nonphysician provider (NPP) will receive the patients and coordinate their care with the physician in triage.
To implement this strategy, we first had to identify an area of the ED that we could assign as the mid-track. We attempted to do this within the ED by reassigning one of the four geographic districts. However, the other districts were quickly overwhelmed with ESI level 1 and level 2 patients, and a disproportionate amount of acuity was being handled by the remaining three districts. This resulted in a number of complaints from the staff, and we terminated the pilot after the initial 1-month period. However, we needed to identify another space to house mid-track.
The ASU is directly above the ED, proximate to the ED staff and our radiology services. This area has operations between 6 a.m. and 6 p.m., with a significant decrease in census at 4 p.m. We approached administration, and approval was obtained to use this area after 4 p.m., with certain caveats:
- We would only occupy one area of the ASU from 4 p.m. through midnight. The other areas would continue to operate, and some areas would be prepped for the next operating day and left undisturbed.
- Housekeeping had to be involved and would be responsible for cleaning the area used by the ED once we left the ASU after midnight.
- The ED would be responsible for bringing up supplies needed for our patients.
- The ED purchased 12 reclining hospital chairs for our patients to use. No stretchers would be used for this project, as we felt patients needed to be ambulatory to qualify for care in this location.
- The ED identified nursing staff and clinical staff to supervise the patients. We identified the nurse practitioners as the ones to supervise the patients and LPNs to assist them. All care would be coordinated with the physician in triage.
- Security had to be involved. We placed security personnel on scene in the ASU during the 8 hours of operation. This was done only as a precautionary measure.
- A protocol had to be developed to identify what types of patients would be best suited for care in this environment. It would also dictate the time of day that new patients would no longer be transferred to the ASU, as well as the procedure for transferring existing ED patients in the ASU back to the ED when the ASU-ED project ended for the day (at midnight).
- The medical staff had to be informed that patients might be in this area, as this was a new protocol. This could be accomplished at general staff meetings and via notices and letters.
- The ED attending staff had to familiarize themselves with the protocol and the details outlining the expectations for patient selection as well as hand-off of patients that straddled shifts. This process of education for the ED attending physicians as well as the ED staff was expected to take several months.
- Once the project was started, feedback would be requested constantly and data reviewed. Protocol adjustments could be made based on this feedback process.
We also had to identify a location within triage that the physician could occupy. We have five triage bays, and one is currently used for performing EKGs. This bay will be used for the physician. It contains a computer for documentation and an exam table/stretcher for evaluations. The physician in triage would only see a patient after the triage nurse assessed the patient and determined that the patient qualified for care under this new protocol. The physician would have the right to reassign the patient to the main ED if he or she felt that the severity of illness warranted it.
Conceptually, we realized that adding more space would not necessarily address the core problem: inpatients occupying ED beds and increasing the throughput times for all ED patients. However, given our options, this approach seemed to allow us to address the issue with expediency, while simultaneously developing programs to address the inpatient aspect of the throughput issue.