There was a very humble emergency ward. Long long ago it was setup and was now running like a top. This is where the internal medicine staff were located. This is where the internal medicine problems would come in to be checked out by internal medicine and if there was a genuine problem they would be put into a bed and treated.
The problem was, at least to the administration types, not really enough people coming to the emergency ward. Four or five a day is simply too small of a number. Thus came the decision to combine the internal medicine from the emergency ward with the (surgical) emergency room, thus having a single emergency room to accept all of the patients.
It was only after both the internal medicine surgical ER were combined that a new trend was discovered. It seems that the number of patients have started to climb. Well, this was a bit of a surprise as the surgical ER had scheduled its own patients to fit with its own schedule. It was later discovered that the reason that the number of patients were increasing was because in the surgical ER the first point of contact was a secretary. It was her decision on who to see, and if it didn’t appear to be a surgical topic, they were basically told to go see their own GP.
Uh, what happened to the emergency ward? The rocket scientists in administration have taken the internal medicine people out and have turned it into an intermediate care ward. This ward will have patients on monitors and long term patients. This is a skill set that is more in line with the intensive care unit and thus the experience ER personnel are jumping to other departments and hospitals. The actual future for the emergency ward is still not known even after many months.