With a large percentage of hospital visits each year, emergency departments (EDs) are among the earliest lines of defense in US healthcare. In 2014 and 2015, there were 141 million and 136.9 million US ED visits, respectfully. Recent research reports that EDs have contributed to approximately 47 percent of US hospital-associated care. This white paper discusses how building better ED care models can help provide effective and efficient care to healthcare organizations.
The Centers for Medicare and Medicaid Services monitors quality and timeliness of care as part of value-based payment models. In 2013, measure OP-22, patients who leave the ED without being seen (LWBS), and OP-20, door to diagnostic evaluation by a qualified medical professional, were added as quality measures to the value-based payment system. As organizations embrace these added quality measures and adopt efficient ED care models, patients can avoid delays on high-value days in the ED.
The combined increase for demand and utilization of EDs, coupled with the continued expansion of ED throughput metrics into value-based purchasing, has led to departments investigating more efficient processes for providing care. Two models that have come to light in recent years are the placement of a qualified medical provider in the ED triage area and split-flow or vertical-care areas.