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4 Ways to Accelerate ED Triage, Boost Revenue

Joe Cantlupe, for HealthLeaders Media, October 13, 2010

For a long time, waiting has been almost synonymous with emergency departments in American hospitals.

But hospitals are streamlining their emergency departments to reduce waiting times as EDs continue to be swamped with increasing numbers of patients.

In 2009, Americans averaged 4 hours and 7 minutes in ED waiting rooms before being seen. And more people are expected to be crowding into EDs over the next several years. Emergency visits may increase as much as 5% to 10% over the next several years in the wake of the healthcare reform law.

Waiting in the ED often has a negative impact on patients' attitudes, with many simply deciding to leave the hospital, despite needing care, and despite the likely consequence of poorer health outcomes. The unfolding scenario has a potentially detrimental impact not only on the patients themselves, but also on overall hospital business.

To meet demands of patients, hospitals are working diligently to ramp up services and decrease wait times by restructuring waiting areas, placing nurses and physicians in entrance areas for "fast track" services, evaluating serious and nonserious conditions among patients in the ED, or evaluating specialized conditions, such as asthma, to improve patient flow.

Such innovations not only have improved patient care, but they inevitably feed hospital revenue because patient care usually begins with the ED, hospital officials say. There were nearly 117 million patient visits to the nation's emergency rooms in 2007, a 23% increase over a decade earlier, or 39.4 visits per 100 persons, according to the National Health Statistics Reports.

By making improvements to the ED, "there has been a positive impact even though the emergency department is not a money maker, per se," says Valerie Norton, MD, medical director for the ED at Scripps Mercy Hospital in San Diego. "You can't look at it in isolation as a separate silo. It's a feeder of inpatients for the hospital. Urban EDs are admitting 20% of the patients who come through the ED. It's very good revenue for the hospital and we are able to increase the volume."

Hospitals also are under increasing pressure to improve EDs, not only because of the need to serve additional patients but also because of the competitive nature of the services, says John Federspiel, MBA, president and CEO of the 128-staffed-bed Hudson Valley Hospital Center in Cortland Manor, NY.

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1 comments on "4 Ways to Accelerate ED Triage, Boost Revenue"


Roger Heath (10/13/2010 at 8:37 AM)
Teletriage may be safely done actually before a patient even reachs the hospital adding front line intelligence to ED scheduling. Business models even have interaction with 911 which may hand nonemergent calls to an institution. A recent report by the Controller of the City of Philadelphia estimated $2.5 million in savings too. For a long list of reference materials see: http://www.lifebot.us.com/teletriage/ Roger Heath