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Half of EDs overcrowded, leaders report

In a survey of nearly 300 respondents in operations, clinical work, finance and information, 43 percent of health leaders reported that ED patient flow was their biggest strategic challenge, followed by physician alignment and adherence to quality goals and reimbursement challenges, each at 13 percent. An overwhelming 95 percent said they are working on efforts to improve throughput, including a fast-tracking area for less acute illnesses or injuries (65 percent), a triage medical evaluation process (56 percent), coordination with inpatient floor nurses (55 percent) and a streamlined registration process (54 percent). Only a quarter saw enlarging the ED as a solution to addressing efficiency.
"We need to examine how we look at the ED and try to find ways to relieve pressure from it that cascades through the hospital systems," Philip A. Newbold, President and CEO of Memorial Hospital & Health System and Elkhart General Healthcare System in South Bend, Ind., said in the report. Newbold said that solutions include express care or around-the-clock urgent care services.

The report confirms conventional wisdom that the industry is biting its nails over ED overcrowing. As one healthcare leader noted in the report, some patients see the ED as their only care option--whether hospitals like it or not. The report also offers some solutions, such as tending to the most urgent cases first, creating separate areas or freestanding buildings for less acute cases and improving coordination among providers--all with the patient (and experience) in mind.