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Challenging Physicians to Help Improve the ED

Joe Cantlupe, for HealthLeaders Media, May 24, 2012

Parkland Health and Hospital System in Dallas, struggling to conform to a corrective action plan to correct "serious deficiencies" documented by the centers for Medicare & Medicaid Services, has been making progress in improving its emergency department. But it is still falling short in making improvements associated with its emergency department.

Fixing an ED is a slow process. A few months ago, Thomas Royer, MD, interim CEO of Parkland, told me how the hospital ED volume spilled over the night before we spoke. "We had 200 people waiting in the Emergency Department to be seen. We had to go on total diversion because we had no beds in the hospital," Royer said.

Problems of the ED linger, of course, not only at Parkland, but elsewhere in the nation. This is reflected in the May HealthLeaders Media Intelligence Report, "Volume, Flow and Safety Issues in the ED." "The ED can get backed up with patients needing inpatient beds, leaving us working out of three or four rooms where we have a 25-bed capacity and 10 stretchers in the halls," a director of emergency service services says. 

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2 comments on "Challenging Physicians to Help Improve the ED"


stefani daniels (5/25/2012 at 9:31 AM)
Based on research in the literatures, most ED waiting rooms are filled with people that do not require ED resources. So why aren't hospital execs doing more to remedy? It seems that 56% of your respondents are by implementing medical triage. Once the EMTALA standard is met, the patient should be referred to primary care services....or would that be competition to the community physicians?

Angelo Falcone (5/25/2012 at 6:38 AM)
Interesting article. In our experience flow problems in the ED can be attributed to 1/3 front end and 2/3 back end issues. While the ED itself can (and should) fix the front end through process changes such as straight backs and more efficient departmental processing such as rapid evaluation areas and discharge lounges the bottleneck at the back end is the major rate limiting step. Hospitals that have fixed that problem only do so when senior hospital leadership make it a priority. Otherwise it is lip service.