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Fewer Emergency Dept. Visits vs. Right Care at Right Time

By jfellows@healthleadersmedia.com  
   May 07, 2015

"We saw a 40% increase in new patients, and we can surmise that we are so close to Atlanta that some of the patients decide to come here," he says. "It could also have to do with high deductible health plans."

To accommodate the unexpected spike, Haney says the hospital added nurses and readjusted the ED physician shifts. Grady is also planning a new emergency department. An additional 15,000 square feet of space will be ready by late next year.

Having two hospitals that are close to each other with similar ED facilities suggests that although ACEP's sample size for its survey is small, the results shouldn't be dismissed.

Implications for Patients
ED physicians work diligently to quickly attend to patients; however, a patient's experience in an emergent situation can color the rest of their stay if they're admitted to the hospital. Grady and WellStar Paulding are paying attention to the patient experience in their EDs. Grady is focusing on reducing its door-to-provider time, which is down to 98 minutes from 133 in 2013.


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At Wellstar Paulding, they're aiming to see 75% of patients in under 180 minutes. As of February, they were making strides, seeing 10% of patients in under 90 minutes. The hospital received three stars from CMS for patient satisfaction. Grady received two stars. The best rating a hospital can get is five stars.

While patient satisfaction and experience in the ED isn't formally being measured by CMS yet, it is an important component of the total hospital experience, and an important site that patients will continue to demand care from, and can't be ignored, says Angela Gardner, MD, FACEP, past president of ACEP, and an associate professor of emergency medicine at UT Southwestern Medical Center in Dallas. She believes the survey results ultimately show that diverting ED patient is ineffective.

The Right Care at the Right Time
"Spending on emergency care only accounts for 2% of the federal health care budget," she says. "Eliminating unnecessary visits as defined by policy makers, would only save pennies. Because people may not be able to determine whether something is an emergency or not without medical evaluation, potentially very sick people may be denied access to care."

The concern over treating patients appropriately is very real, says Haney. WellStar Health System has a total of seven urgent care clinics, and there are plans to add more, but the level of its ED patients' acuity is growing, which those types of clinics can't handle.

"Our patients need to get to the right place," he says.

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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