Hospitals are making a push to fix one of the most irritating issues in health care: the emergency room.
Armed with new research and strategies borrowed from the business world, some facilities are trying to ease the frustrating experience of waiting, filling out forms, explaining a problem—and then waiting some more.
In many cases, making things smoother for patients means completely rethinking how emergency rooms work. Some hospitals are scrapping the traditional triage process and putting patients straight into exam rooms, while others are creating treatment areas for patients with only minor complaints. Other facilities are installing software to monitor ER wait times…
Since the onset of the coronavirus pandemic, the number people visiting emergency rooms (ER) has dropped significantly. Emergency room overcrowding due to non-emergencies once seemed like an intractable problem with no easy solution. Now many are wondering where all the patients have gone.
In the typical emergency room, demand far outpaces the care that workers can provide. Can the E.R. be fixed?
The provider-in-triage model was created by health care consultants who applied the Toyota model of lean production to health care. Hospital administrators and emergency department directors embrace lean production with the hopes of reducing inefficiencies and improving patient throughput. But while a manufacturing model that favors standardization and reproducibility might be ideal for making quality SUVs, it leads to mediocre medicine.
“My first reaction was: This is nuts. There is no relationship to the actual cost.”
An ER patient can be charged thousands of dollars in “trauma fees” — even if they weren’t treated for trauma.
Instead of opioids, an E.R. in New Jersey now treats
many pain patients with alternatives like laughing
gas, trigger-point injections and even a therapy harp.
Many cities and towns now have urgent care or “walk-in” clinics, sometimes attached to hospitals, where patients can be seen without appointments or long waits.
The next frontier in digital health may be one of the most unlikely: the emergency room. The Emergency Department Express Care program at NewYork-Presbyterian/Weill Cornell Medicine is among the first telemedicine programs of its kind in the emergency department of an academic hospital. The goal: to reduce waiting times and get patients with non-urgent cases in and out of the emergency room efficiently without compromising care.
But what you need to know, America, is that in the ER you don’t ever want to be first. First means you have a chance of not walking out of those double doors. First means that your family may not see you again.
“For too long the medical profession has neglected the study of its own personnel and focused on patient care,” said Manit Arora, a surgeon and lecturer at University of New England in Armidale, Australia, and University of Queensland in Brisbane who studies burnout among health professionals.
New data shows how emergency rooms take advantage of their market share, at the expense of their patients.
A new study uncovered inequality in hospital billing practices.
Wars and diseases, intrigues and coups and all the rest are indeed interesting things. But more important, and more terrible, is the fact that grieving humanity suffers at the center of it all.
Sandra Schneider, president of the American College of Emergency Physicians, says doctors are receptive to efficiency programs, but warns they are just a "Band-Aid" on larger problems, such as the number of patients who are admitted to the hospital but left in beds in the ER because there are no inpatient rooms available. And being treated in waiting rooms and hallways, she says, can be "degrading and difficult" for patients.
America’s health care is the costliest in the world, yet quality is patchy and millions are uninsured. Incentives for both patients and suppliers need urgent treatment.
Reporter Sarah Kliff is collecting emergency room bills as part of a year-long project focused on American health care prices.
"The health care market is not a market at all. It's a crapshoot." That's where, over 30 pages later, Time magazine's longest-ever article ended. It asked, in the course of its investigation into the industry, "Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college?"
As the availability of ED care has exploded, primary-care and specialty physicians feel more comfortable curtailing their after-hours clinical availability, allowing unscheduled and poorly documented patients to go to the emergency department. Not surprisingly, a significant amount of nonemergent and less-urgent care is provided in the modern emergency department. This ends up costing more money, distracting highly valued resources with less-critical needs...
When a child has a medical emergency, the first instinct is to rush to the nearest hospital ER. But, many emergency rooms are ill-equipped to treat infants and children and they are staffed with doctors and nurses who may not be trained in the specifics of pediatric care.
The new Medicaid recipients used ERs more often for all kinds of health issues, including problems that could have been treated in doctors' offices during business hours, according to the study published Thursday in the journal Science. Earlier studies had found the same patients used more of other medical services as well.
Don’t get me wrong. Antibiotics are great. Since their discovery, they saved millions of lives around the world fighting infections that were once common killers. But our use of antibiotics — often overuse, misuse or unnecessary use — has contributed to antibiotic resistance. It is a global public health emergency.
Complaints about emergency room care are legion, with stories of distress frequently voiced both by patients and by the relatives and friends who accompany them to the E.R. Sometimes these complaints are warranted, as when patients with abdominal pain wait unattended in the E.R. for hours until their appendix bursts. But more often than not, they stem from a misunderstanding of how emergency rooms operate and how patients themselves can be helpful.
“Twenty-five years ago you saw a service station getting put on every corner, then 10 years ago you saw banks, then CVS and Walgreens. Now you’re seeing urgent care and freestanding emergency departments. The latter you may not be seeing as much in the next years,” Trabold said.
No single solution exists for alleviating crowding in emergency rooms, but a new study identifies four key strategies that have reduced the problem.
Each region of the U.S. has the same four most common complaints, just in a different order.
HMOs were basically unable to use the means at their disposal to brake ER utilization — pre-authorization, denials — and were also discouraged from using economic means — $50 copayments — to give enrollees incentives to rely on alternative sources of care.
“That means all they have are the PCPs, who are supposed to welcome the opportunity to add more patients to their already busy schedule in case they have an emergency.
. Often all that can be done is to provide prescriptions for antibiotics and pain medications, which doesn’t solve the underlying dental condition. Dentists and physicians have recognized this and are working together in communities across the country to help connect patients with the dental care they urgently need.
The ER has become the de facto multi-specialty clinic of the 21st century. The modern ER no longer just serves as the place for sewing up wounds or triaging patients for more acute care.
The setting for the show is chaotic but somehow the directors and writers of the different episodes manage to hold it all together and the assorted emergency cases are fully fleshed out. It also helps that each episode manages a surprise twist or two that are completely unexpected.
ERs are notorious for long waits, endless forms and inconsistent care. Now researchers and hospitals are rethinking the ways they work—with impressive results.
Doctors and nurses tend to resist changes to their care-delivery methods, insisting that the old way has worked for centuries. The truth is, forcing patients to wait in the Emergency Department is unnecessary and dangerous. Improving patient flow can and does reduce hospital costs while improving clinical outcomes.