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ED Woes Bad Today, Worse Tomorrow

Joe Cantlupe, for HealthLeaders Media, July 12, 2012

In their report, researchers analyzed data from the yearly National Hospital Ambulatory Medical Care Surveys from 2001 through 2008. The surveys abstract patient records from a national sample of hospital EDs.

These days, Pines agrees that hospitals are putting in place procedures to try to reduce boarding "without building new hospital towers." He also noted that while imaging increased dramatically between 2001 and 2008, "it has leveled off" in recent years, he says.

All good signs. But, there's still that one thing, Pines says.
"How can we get doctors to order fewer tests when patients come into the emergency department?" he asks. "That is a much heavier lift."


Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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2 comments on "ED Woes Bad Today, Worse Tomorrow"


chris thomson (7/13/2012 at 8:33 AM)
The volume of testing is also directly related to the 'new' role of emergency departments in this era of more comprehensive care in the ED. Many patients treated frugally for their acute care needs in the traditional realm of emergency medicine simply return for follow up since they lack primary care. The role of the emergency department has extended far beyond emergencies. The options are to ignore this need or move to accommodate this need, and accommodating this need for care has driven increased care intensity. The pressures in the emergency department must be evaluated in the context of the healthcare system and its inadequacies.

Gus Geraci, MD (7/12/2012 at 3:36 PM)
You end with, "How can we get doctors to order fewer tests?" That's similar to asking, "How can we get pilots to crash fewer planes?" The reasons for test ordering go way beyond the desire of the physician, and to decrease the burden of time testing takes requires a thorough analysis of why tests get ordered, many of which you listed. How about phrasing the question, "How can we decrease the number of unnecessary tests ordered?" Thus not blacing blame on physicians, but including all the reasons unnecessary tests are ordered.