Freestanding EDs Can Make Providers Healthy

By Keith Konkoli, for HealthLeaders Media , July 30, 2010

What were the results of this pioneering effort in freestanding EDs?

  • It was first to market and the first system in the state to build a freestanding ED.
  • It has expanded its presence and market share in the northeast Indianapolis suburbs, as evidenced by a 67.2% increase in its ED patient volumes in the area during the first nine months after the building opened.
  • The new facility increased convenience and access to care for suburban residents, adding emergency services to existing urgent care facilities.
  • St. Vincent Medical Center Northeast almost instantly became the system’s busiest ED in the area, accounting for more than 48% of its total ED patient volume in the Exit 10 market.
  • Patient volumes eased by a total of almost 14% at the system’s four other EDs in the market, shortening wait times and reducing overcrowding?even though total ED use increased.
  • Only 13% of patient waiting times at the new freestanding ED exceeded 30 minutes ? far below the national average.
  • The freestanding ED created a new source of referrals for St. Vincent-affiliated physicians.
  • Third-party financing kept the whole project off-balance sheet, preserving the system’s capital.

    St.Vincent reaffirmed its commitment to the concept by collaborating with Witham Health Services on the development of 42,500 square foot freestanding ED in Boone County. That facility opened in October 2009.

    Another system that is actively developing a freestanding ED is TriHealth, a not-for-profit system with two hospitals and about 50 other locations in the Greater Cincinnati area.

    TriHealth’s Good Samaritan Hospital is developing Good Samaritan Medical Center at Western Ridge, a 45,000-square-foot facility in the northern portion of Cincinnati’s West Side. Plans call for primary care and specialty physician offices, imaging, lab services, and a 24-hour ED with ambulance access and a helipad. Construction is under way and the facility is scheduled to be operational by this fall. The project is envisioned as the first phase of a multi-building medical and retail development.

    A powerful strategy

    Freestanding EDs are not a cure-all for everything that ails emergency services. Some healthcare industry observers have also complained that freestanding EDs might increase costs by attracting patients with non-emergency ailments. Others worry that standalone EDs aren’t equipped to handle the most critically ill patients.

    But proper planning for hospital-affiliated facilities can mitigate those types of concerns. And as demonstrated by the experiences of St. Vincent Medical Center Northeast—and the growing number of freestanding EDs nationwide—the benefits can be considerable.

    As a financial tool, a competitive strategy, and a way to increase patient convenience and satisfaction, freestanding EDs can deliver many benefits—not the least of which might be a welcome reduction in the kind of horror stories mentioned at the start of this article.

    Keith Konkoli is a Senior Vice President with BremnerDuke Healthcare Real Estate’s midwest region. He may be reached at

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