To combat overcrowding and unneeded visits to the emergency department, one Nevada hospital has united its ER physicians and hospitalists under one banner.
Sunrise Hospital and Medical Center, a 701-bed acute-care facility located near the Las Vegas strip, brought those distinct groups of doctors together under one medical director, according to an article from Hospitals & Health Networks. After the passage of the Affordable Care Act and the state’s expansion of Medicaid, the hospital’s number of emergency room visits increased significantly; in 2016, 157,000 people visited Sunrise’s ER, the largest number in the state.
To tackle the problem, HH&N reports that Sunrise created a 30-bed observation unit, with dedicated providers and case managers, to reduce their hold hours, and the streamlined processes have gotten patients out of the ER and to other parts of the hospital faster. Since implementing the changes, Sunrise has seen its hold hours drop 79% to about 6,000 hours a month from an average of 20,000.
The new program has also increased collaboration between clinicians, and trust between nurses and doctors thanks to a shared set of goals and a culture that emphasizes teamwork.
Another strategy for hospitals that want to reduce ER overuse is to analyze the population of patients who make unneeded or repeat visits. ED “super users” often have complex conditions or unmet social needs, so early interventions, like improved care coordination to connect those patients with needed services, can keep those patients from making repeat visits. Predictive analytics can provide a guide for future usage trends that allows providers to develop more effective strategies.
Some hospitals turn to telehealth options to reduce ED overcrowding. Baptist Health South Florida, for instance, offers “tele-triage,” which allows patients to connect with doctors through video conferences to move them through emergency care more quickly.