Best EDs Focus on Flow

This article appears in the May 2012 issue of HealthLeaders magazine.

Among the greatest challenges in the emergency department is improving patient flow, and this comes with a sense of urgency amid deep concerns about patient safety due to overcrowding. In addition, the latest HealthLeaders Media Intelligence Report reveals that healthcare leaders expect worsening ED revenue margins and an increasing volume of uninsured patients.

Hospitals are trying to reduce ED congestion and wait times by creating systems to care for patients with lower acuity in one area, and by freeing up beds for those with more serious illnesses. They are improving coordination among nurses and physicians to ensure the sickest patients are seen quickly.

But while many healthcare leaders have identified patient flow as their main challenge, many continue to deal with overcrowded EDs and concerns about patient safety. When asked about their greatest strategic challenge involving the ED, 43% said patient flow. Another 46% described their EDs as overcrowded, and of that group, 93% expressed concern about patient safety as a result of the overcrowding. That represents about 43% of all respondents expressing concern.

"You have multiple things going on—the wave of Baby Boomers about to hit retirement age, being Medicare eligible," says Randy Davis, senior vice president and CIO of 72-bed NorthCrest Medical Center in Springfield, Tenn. "Across the U.S., there is a huge access issue with the shortage of primary care physicians, and with anticipated higher volume in the ED. Access to a primary care physician may be limited, leaving people to go to the ED as their only choice."