As the healthcare industry focuses increasingly on population health while seeking to improve quality and contain costs, the role of the emergency department is expanding and evolving.
This year, 130 million patients will show up at the ED, according to John G. Holstein, director of Zotec Partners. "The ED has been called the nexus of care, the hub of the enterprise," he said.
At the Becker's Hospital Review 5th Annual Meeting in Chicago on May 16, Mr. Holstein moderated a discussion with Brent R. Asplin, MD, chief clinical officer at Cincinnati-based Catholic Health Partners, and Alan Channing, president and CEO of Chicago-based Sinai Health System and past chairman of the Illinois Hospital Association, about measuring quality and value in the emergency department. Here are three key insights Dr. Asplin and Mr. Channing offered into the part the ED plays and the department's future in a value-based care world.
1. The role of the ED director is expanding dramatically. Traditionally, Dr. Asplin says the leader of the ED played a hospital-based role. However, the scope of that position is becoming much broader as providers seek to manage population health. "We now need the ED to think not just outside the walls of the ED but outside the walls of the hospital…and help answer the question of what's needed to prevent this admission." he said.
2. EDs need to focus on patients with chronic conditions. Mr. Channing said his health system has put case manager navigators in the ED to support people with chronic diseases, and the system pays special attention to "frequent fliers." For instance, the system gathered data and found one patient with sickle cell disease who showed up to the ED every three days. So Sinai worked to get the patient enrolled in a care program at a sickle cell disease center close by to help manage the condition. "It's those kinds of things we all need to be thinking about," Mr. Channing said.
3. EDs will have an increasingly larger presence in hospitals. "I think the footprint will in some circumstances be larger in hospitals to create the space and the resources to sort through the 'tweeners,'" Dr. Asplin said, referring to patients who aren't obviously ready to be admitted or to go home.
Mr. Channing agreed that the ED's presence in hospitals will grow as inpatient care declines. Ultimately, he said the ED will always play an important part in the healthcare system. "We're never going to see EDs disappear," he said. "There are just too many things happening in the environment. They will always be there."
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