Challenging Physicians to Help Improve the ED

Joe Cantlupe, for HealthLeaders Media , May 24, 2012

Intelligence Report advisor, Gary Tiller, CEO of Ninnescah Valley Health System, which operates the 25-staffed bed Kingman Community Hospital, 25 miles west of Wichita, KA is pessimistic.  "We are going to get overrun. I don’t know if we are going to be able to handle it, truth be known. It’s going to be a mess, honest to God," Tiller says, predicting the consequences when more uninsured use the ED.

Some may consider Tiller’s comments hyperbolic. Yet his words convey the depth of the daily grind, echoed by Parkland’s Royer and the unnamed director of emergency services in the Intelligence Report. Their words underscore the obstacles faced by this country’s EDs. And the report shows that among the greatest challenges in the ED is improving patient flow.

In the survey, nearly half of the respondents— 46%—described their EDs as overcrowded, and of that group, 93% expressed concern about patient safety. They also express concern about financial implications. About 80% are expecting their ED revenue margins to worsen as a result of healthcare reform, and 78% say their reimbursement will worsen.

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2 comments on "Challenging Physicians to Help Improve the ED"

stefani daniels (5/25/2012 at 9:31 AM)
Based on research in the literatures, most ED waiting rooms are filled with people that do not require ED resources. So why aren't hospital execs doing more to remedy? It seems that 56% of your respondents are by implementing medical triage. Once the EMTALA standard is met, the patient should be referred to primary care services....or would that be competition to the community physicians?

Angelo Falcone (5/25/2012 at 6:38 AM)
Interesting article. In our experience flow problems in the ED can be attributed to 1/3 front end and 2/3 back end issues. While the ED itself can (and should) fix the front end through process changes such as straight backs and more efficient departmental processing such as rapid evaluation areas and discharge lounges the bottleneck at the back end is the major rate limiting step. Hospitals that have fixed that problem only do so when senior hospital leadership make it a priority. Otherwise it is lip service.




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