Long Recurring Problems in Tradition Hospital ERs

In Ellie Kincaid’s September 12, 2017 article, “How to Fix the Emergency Room,” published in The Wall Street Journal, she talks about the long recurring problems of emergency rooms (ER) nationwide, and how these recurring problems are paralyzing the healthcare system for acute care needs.

As Kincaid discusses throughout her article, patients are not getting the prompt patient care they need, and often have long wait times for the following:

  • Seeing Physicians in a Timely Manner
  • Being Triaged
  • Receiving Lab and Radiology Results
  • Filling Prescriptions
  • Receiving Timely Care and Medication for Complications Associated with Chronic Conditions (i.e., heart disease and diabetes)
  • Admitting and Transporting Patients to a Ward
  • Receiving Discharge Summaries and Patient Instructions

Kincaid further explains that there are things that happen during the week in hospitals that affect patient wait times in the ER. For example:

Doctors often schedule surgeries early in the week so that
patients will recover by the weekend (and doctors won’t
need to look in on them past Friday). The result: Early in
the week, elective patients take up a lot of hospital beds,
and there’s no room for ER patients who have been admitted.
So these patients must stay—or “board”—in the ER instead,
reducing its capacity and bringing longer wait times.
The uneven surgery scheduling “creates a very unbalanced
demand for inpatient beds,” says Dr. Pines. Boarding is
“the elephant in the room when it comes to crowding.”

Over the years, there have been gradual improvements in ER processes, some of which Kincaid discusses throughout her article, but no one has really resolved the issues. ERs have long wait times, and sometimes patients will avoid getting care until the next day when they can see their primary care physician. Unfortunately, patients would rather stay at home in bed than wait in an overcrowded ER to see a doctor.

So what is the answer?

Maybe there is no one way to fix this long recurring problem for traditional ERs, but there may be an alternative option — Freestanding ERs.

Read: Freestanding Emergency Rooms – Possibly a Life Saving Alternative

10 Benefits of Freestanding ERs

Freestanding ERs are fully staffed with Board Certified Emergency Medicine Physicians, and Intensive Care Unit (ICU) and ER trained nurses. By choosing a patient-centered organization, patients gain 10 major benefits:

  1. Open 24 Hours a Day, 7 Days a Week, 365 Days a Year
  2. No Wait Times, Get Immediate Care
  3. Fully Equipped Facility with State-of-the-Art Diagnostic Technology, Including X-ray, Ultrasound, and Cutting Edge 64-Slice CT Scanner
  4. On-Site Radiology Consult, Receive Immediate Diagnosis
  5. Full Service Lab, Receive Quick Laboratory Results
  6. On-Site Pharmacy with 72 Hour Prescription Service
  7. Transfer Agreements with Local Hospitals (Bypasses the Hospital’s ER)
  8. Immediate Access to Your Medical Records
  9. Immediate Follow Up Care via Telemedicine Services
  10. Equitable Costs, Similar or Lower than Hospital ERs’

Most Insurance Plans Accepted

Freestanding ERs generally accept most private insurance plans, but at this time no freestanding ER can accept government insurance plans, such as Medicare, Medicaid, CHIPS and Tricare, as the state does not allow this. They do, however, offer self-pay rates at a 50% discount for those patients needing care who have those plans.

If a patient is experiencing a life-threatening emergency, they will not turn them away regardless of their ability to pay.

They also accept other forms of payment, like cash, Visa and MasterCard.

What is the Difference Between Hospital ERs and Freestanding ERs?

The main difference between hospital ERs and freestanding ERs is that they can provide comprehensive emergency evaluations, treatments and diagnostic testing (including ultrasounds, x-rays and full lab services) more quickly and efficiently. In most cases, a patient can be seen, treated and released within an hour. Since they have shorter wait times, patients have immediate access to care, which is especially important for patients with life-threatening emergencies.

How do They Do This?

Traditional ERs often have high-traffic volume and lower doctor-to-patient ratios, reducing the amount of time medical personnel can spend with a patient. These factors significantly contribute to very long wait times, and sometimes impact a patient’s decision to leave the ER before receiving medical attention. According to the Centers for Disease Control and Prevention’s 2014 National Hospital Ambulatory Medical Care Survey (NHAMCS), a sample survey of visits to Emergency Departments in the United States, conducted from December 23, 2013 to December 21, 2014, 253 patients left hospital ERs before triage, 1390 left after triage, and 1162 left against medical advice. Stand alone emergency centers offer an alternative option for these patients. They provide immediate high quality, attention-focused care, so that patients don’t leave prior to completing their visit for emergency treatment.

For patients requiring more intensive care, they can treat and stabilize the patient, and then direct-admit the patient to a local hospital. Their transfer agreements with local hospitals allow them to direct-admit patients, bypassing their ER, which is another added convenience.

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Footnotes

https://www.wsj.com/articles/how-to-fix-the-emergency-room-1505268780
https://www.cdc.gov/nchs/data/nhamcs/web_tables/2014_ed_web_tables.pdf (Table 25, Page 31)