3 strategies to transform your ED into an asset, not a money drain

The difficulty of optimizing emergency care without raising costs causes many hospital leaders to perceive the emergency department as a necessary evil. Identifying the best strategies for optimizing care and efficiency in the emergency department can be a complicated process since no two are exactly alike.

At Becker's Hospital Review's 5th Annual CEO + CFO Roundtable on Nov. 7, Derik King, MD, FACEP, division president of EM/HM/eHealth Services with Schumacher Clinical Partners, discussed strategies for turning the ED into an asset.

"The emergency department is the crux for value-based purchasing and really is the key to make sure we advance healthcare going forward," said Dr. King.

Here are three strategies for ED optimization.

1. Change the perception: Data presented by Dr. King suggests EDs in the U.S. incur 136 million visits annually, costing the nation $38 billion year. These facts feed the notion that the ED is just a money drain, but Dr. King suggests this evidence is being misinterpreted.

"Really, [the ED is] an asset," said Dr. King. "There's going to be all those people walking out of your hospital with papers with your hospital's name on it ... 50 to 70 percent of your admissions start in the ED. You have to make the ED efficient for those people."

Additionally, quality measures of hospital performance and the HCAHPS survey on patient experience and satisfaction begin in the ED, according to Dr. King. Change management — like the implementation of EMR platforms and other initiatives — also starts in the ED. Therefore, investing in ED optimization is essential to a hospital's success.

2. Don't devote too many resources to avoiding the ED: According to Dr. King, eliminating half of all ED visits for minor illnesses or injuries only saves hospitals 0.2 percent to 0.8 percent of all healthcare costs. Additionally, a full-on commitment to fast care will not benefit all ED patients, as discharges and transitions to other care facilities can often result in complications and readmissions.

"Fast care is not always ideal care for all patients," said Dr. King. "Matter of fact, there are some patients we should take more time with and treat in different care settings ... but you have to commit to that. You have to give the providers the staff. You have to be willing to accept that. Time will eventually translate to revenue for you."

3. Embrace the safety-net functions of the ED: Many Americans across the country will continue to struggle with obtaining access to primary care. For these individuals, the ED is the only place to go for treatment. The Emergency Medical Treatment and Labor Act, which requires anyone coming to an emergency department to be stabilized and treated, will continue to force cost-shifting, according to Dr. King. For this reason, it's important to deliver quality safety-net care and educate patients upon discharge.

"As healthcare providers, we should embrace this. We should want to treat them," said Dr. King. "And then we should teach them what to do next. We should teach them where to go and tell them how to access other pieces of the healthcare system."

More articles on financial management: 
Family caregivers struggle with out-of-pocket costs: 8 things to know 
Fair market value considerations for 6 steps of bundled payment program development 
Managing a patient's episode of care for bundled payment success

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