Emergency Department Strategies
HealthLeaders Media Council members discuss what's driving the increasing patient volume in their ED, and how they plan to handle it.
This article first appeared in the November 2016 issue of HealthLeaders magazine.
Garfield Medical Center
Monterey Park, California
Our organization is expecting increased volume. A lot of it is driven by Medi-Cal—California's Medicare program—expansion, and we treat a lot of capitated lives as well.
We've always had a significant share of Medi-Cal patients, but with Medi-Cal expansion, the patient population has changed. Medi-Cal was once largely a program for moms and kids; the expansion brings in a lot of middle-aged men, and within that group there are a lot of mental health issues, drug issues, and probably more issues with homelessness. So that's part of the new volume.
Disposition is a challenge when dealing with homeless patients. We can't send them home if they don't have one. We've contracted with shelters that have programs that not only give homeless patients a place to live—at least for a couple of weeks while healing—but also have some nursing care available.
When the weather gets really hot or when it's raining, some people who are homeless decide the ER is a good place to hang out, which can be a challenge for us. We've instituted fast tracking in the ER; we can quickly evaluate them, a medical decision is made, and if they don't need medical attention, they can be quickly discharged.