We know many patients presenting to emergency departments don’t necessarily need treatment there. Depending on the severity of a patient’s symptoms, quality care can be had in other, more appropriate settings such as a primary care physician’s office or urgent care. But redirecting patient traffic to these locations is often a challenge.
With more non-urgent visits come longer wait times, extended lengths of stay and decreased patient satisfaction within an ED. So, what can ED leaders do to reduce these non-urgent visits to their emergency departments?
It’s important to first look at the data and determine the scope of the problem. Find out just how many, or the percentage of, patients each month visiting your ED could be treated elsewhere and identify the common causes of those visits. Once you determine the extent of the problem, only then can you begin to alleviate it.
These three tactics outlined below have proven to significantly reduce non-urgent visits to EDs. Hospital leaders will need to tailor a specific and strategic plan based on the issues their ED and community of patients are facing.
1. Telephone Nurse Triage
Developing and implementing an in-house nurse triage system is one innovative way of reducing non-urgent ED visits. By offering patients 24/7 access to trained medical professionals via telephone, nurses can direct patients to quality care in the most appropriate setting based on their needs.
Midland Memorial Hospital in Midland, TX, set up a telephone nurse triage system that employs a software-based algorithm to determine patient acuity. The system allowed nurses to direct patients suffering from non-urgent ailments to obtain the care they need in a more appropriate setting, while encouraging patients facing a serious condition to visit the ED. The result was a reduction in the number of patients present with non-urgent symptoms, which led to a decrease in LOS, wait times and leaving without being seen rates.
2. Real-time Video Consultation
Partnering with emergency medical services to provide real-time video assessments of patients outside the emergency department can also reduce the number of non-urgent visits.
When the City of Houston Fire Department implemented its own Emergency Telehealth and Navigation program (ETHAN), area EDs saw a decrease in unnecessary patient visits after ED-based physicians conducted video consultations with patients in the field.
Once physicians via video determine that emergency care isn’t necessary for patients, the program takes the necessary steps to schedule and provide transportation for patients to a care partner — typically primary care medical homes — to provide continued treatment.
One key element or solution to curbing non-urgent ED visits is collaboration. It’s important to partners and stakeholders who can offer assistance and provide long-term care to specific high-frequency ED users such as individuals battling substance abuse and those experiencing homelessness. Without collaboration and teamwork, reducing non-urgent ED visits may be difficult.
Has your ED successfully reduced the number of non-urgent ED visits? Or is it a problem your ED still faces? If so, feel free to comment below or drop me a line to share your experience.
Agency for Healthcare Research and Quality: “Telephone Nurse Triage System Reduces Use of Emergency Department by Nonurgent Patients, Reducing Wait Times, Length of Stay, and Patient Walkouts”
Agency for Healthcare Research and Quality: “On-the-Scene Video Consultations With Emergency Physicians Reduce Unnecessary Ambulance Transports and Emergency Department Visits, Connect People to Medical Homes”