The study, Impact of Emergency Department Crowding on Outcomes of Admitted Patients, published in the Annals of Emergency Medicine, found that patients admitted to the hospital from the emergency room on days with high ED crowding were 5% more likely to die in the hospital. Those patients also typically spend more time in the hospital and cost more to treat.
The ED crowding problem has gotten worse in the last decade. In the United States, the number of ED visits increased 11%, from 107 million in 2001 to 120 million in 2006. However, during the same period, the number of EDs increased only 4%, from 4,600 to 4,800.
With the Affordable Care Act expected to extend healthcare coverage to another 30 million Americans, the ED crowding problem is not likely to go away. And despite the fact that ED crowding leads to poor care quality and higher costs, the study’s authors say “there have subsequently been few systematic action to address the crisis of ED crowding.” Authors would like policymakers to take up ED crowding as a public health priority.
Perhaps US emergency rooms should consider adopting an ED throughput improvement technique from our European friends. A study published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, found that fast track ED units improve patient flow, decrease patient wait times, lower the average length of stay, and contribute to patient satisfaction and revenue goals.
Fast track units are special part of the ED where a dedicated team (typically made up of nurse practitioners) treats patients with minor conditions that might otherwise be managed in a primary care setting, such as minor viral infections, superficial wounds, minor allergic reactions, broken bones, animal bites, and minor burns. Patients with these minor injuries make up a significant portion (60%-80%) of the emergency room population.
Here at Barton Associates, we have already begun to see state-side EDs establish fast track units. Our team has placed locum tenens emergency medicine nurse practitioners from our talented pool of providers to help improve throughput at facilities nationwide. For more information visit our facilities page.