ED Management Strategies Linked to Revenue Recovery

Emergency departments often "board" patients so higher-paying elective cases scheduled for admission get beds first.

But a study that tested smarter management strategies finds that hospitals can reduce boarding time and bring $3.6 million more in net revenue a year at just one hospital.

The added revenue would come from caring for patients who otherwise would leave without being seen, and for treating patients transported by ambulances that otherwise would divert them to other hospitals, according to the study, published this week in the Annals of Emergency Medicine.

Revenue would also come from avoiding costly complications that are much more likely in patients who are boarded for six hours or more, says Jesse M. Pines, MD, lead author of the study and the director of the Center for Healthcare Quality at George Washington University in Washington, D.C. "There are multiple papers showing clear associations between longer boarding times and higher rates of complications," Pines said.

Pines adds that his study, done with researchers from the Hospital of the University of Pennsylvania and the Wharton School, is the first of its kind to assess the trade-off between potential lost revenue when patients leave or are diverted, and "debunks the conventional wisdom that boarding ED patients in the ER maximizes hospital profits."