5 hospitals creating a better ED experience for patients

Hospital leaders across the U.S. are trying to find creative solutions to reduce boarding in emergency departments, which challenges health systems.  

"Boarding is causing widespread dysfunction, and we feel it every day," Aisha Terry, MD, the president-elect of the American College of Emergency Physicians, stated during an overview of a recent report on the issue. "It won’t happen overnight, but we are one step closer to solutions because we are coming together."

In recent months, emergency medicine leaders have embraced a range of approaches to prevent ED overcrowding and improve throughout, from virtual ED experiences, to implementing community-based programs addressing basic care needs to help free up space for more urgent ED cases. 

Here are five hospitals getting creative with solutions to manage overcrowding in the ED: 

1. Manchester, N.H.-based Elliot Hospital has developed a virtual emergency department experience for patients. The program began in January and allows patients to schedule a telehealth visit for about 15 minutes with one of the hospital's emergency medicine physicians to get their questions answered. If patients require additional care, they are advised to either go to an urgent care location or come in for an ER visit.
    
2. Grand Blanc, Mich.-based McLaren Health now allows patients to schedule emergency department appointments ahead of time to limit the amount of patients waiting in person for emergency care. Patients are able to self-schedule at two of the health system's emergency departments: McLaren Oakland Hospital in Pontiac and McLaren Clarkston (Mich.).
   
   
3. Madison, Wis.-based UnityPoint Health Meriter Hospital opened a new unit that is staffed by nurses and providers who have particular expertise in admission decisions. It opened in July to pilot its use and since then has served more than 1,900 patients. It has kept multiple cases out of the emergency department by providing non-emergency care for patients in the unit's eight beds. In coming months, the unit's capacity will grow to 13 beds.
   
   
4. Charlottesville, Va.-based UVA Health is connecting patients who frequently visit the emergency department seeking care with a program that aims to address root causes behind their frequent health visits to the ER. The initiative enrolls between 20–25 patients at a time who are referred to the program by ED staff. Once referred, they are contacted by UVA Health's community paramedics, who review the patient's medical records and then conduct a home visit to learn more. They then connect the patient with specialists and primary care providers to address other issues. It has prevented 50 ER visits so far in the last year since the program's introduction.
   
   
5. York, Pa.-based WellSpan Health has cut its emergency department utilization by 32% after implementing a new program that incorporates behavioral care and addiction treatment. A designated team connects patients with a combination of medical, behavioral care and addiction treatment. Its premise is to address any unmet needs like food and housing insecurity, and set patients up with a wellness plan and resources to adhere to it so they stay out of the ER for basic care. It also uses a mobile crisis unit to address certain cases alongside police who respond to crisis calls. The two efforts have reduced the number of patients coming to EDs for behavioral care by 50% and has also led to a 90% decrease in patients who stay longer than 24 hours.