Thus, new patients that arrive at the ER may not be given a room to be seen, especially those with less serious issues that aren’t life-threatening. However, this creates a flow and throughput issue: if there are no beds available in the hospital to accept a sick patient from the ER, this means that the patient waits in the ER until a bed is available, as they may not be stable enough to go home and return at a later time.

Other than scheduled surgeries or extraneous medical situations that occur inside the hospital, the emergency room is one of the main avenues by which patients are admitted to the hospital for more critical care and monitoring. GettyĪdditionally, ER flow may also be impacted by the physical number of beds available at the facility.

Hospital emergency, medical staff pushing patient on gurney. The unfortunate reality is that a such a wide array of medical emergencies, which requires three very different treatment approaches, can come into the ER doors at the same time, creating a disparity in the resources that non-emergent patients have immediate access to, thus often leading to poor patient satisfaction. Different scenarios activate different treatment algorithms: a patient that comes in with acute chest pain that radiates to his jaw activates a very different treatment algorithm and severity index than does a healthcare worker that comes in with a potential needle-stick exposure, which is also different from a third patient that comes in with a cough that has persisted for four days. Unlike other service industries, emergency medicine cannot work on a “first come, first serve” basis, but rather must focus on the most emergent medical issues first.

Therein lies the problem: why would a patient with cold-like symptoms wait 24 days to see a primary care doctor, when they could simply go into the ER and have an array of blood and imaging tests done with a conclusive answer in a few hours?Īnother aspect of ER patient flow is triaging, which entails determining the seriousness of a medical situation and prioritizing treatments accordingly. The same study indicated that respondents “consciously chose the ER because the care was cheaper, the quality of care was seemingly better, transportation options were more readily accessible, and, in some cases, the hospital offered more respite than a physician’s office.” Of course, patients cannot be blamed for this, as the wait-time to book a new-patient appointment with a primary care physician has also increased to an astounding average of 24 days in large metro areas. In a study by the Robert Wood Johnson Foundation, it was found that avoidable ER use causes nearly $30+ billion dollars in healthcare costs yearly. One of the most prevalent systemic issues that contributes to prolonged ER wait times is that the modern emergency room has become a primary care hub for millions of Americans who use it for preventable and non-emergent cases, simply leading to an overload issue.

Emergency 20 years