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EMERGENCY: Which patients are likely to benefit the most from emergency care?

…we identified 51 condition groups most sensitive to emergency care, conditions where timely, high-quality emergency care is expected to make an impact on mortality and morbidity.”

A comprehensive list of emergency care sensitive conditions (ECSC) developed by an expert panel to represent adult patient conditions that are most appropriate for emergency care is the focus of this research article.  The conditions were then paired with national ED utilization data.  There were about 16 million (14 percent) of the roughly 114 million total ED visits in 2016 that were considered to be ECSC.  Here are the utilization data for the top 5 most frequent of these ECSC visits:

  • 10.7 percent of all ECSC visits were related to sepsis and SIRS
  •   7.9 percent were related to pneumonia
  •   7.9 percent were related to chronic obstructive pulmonary disease
  •   6.1 percent were related to asthma
  •   5.7 percent were related to heart failure

You can also determine those conditions that are most likely to be admitted after presenting in the ED.  Here are the 5 highest:

  • 94.8 percent of patients with sepsis and SIRS were admitted
  • 88.1 percent with respiratory failure
  • 83.9 percent with femur fractures
  • 80.0 percent with cerebral infarction
  • 79.7 percent with meningitis

Other patient disposition data and median emergency department charges are also included.

Source: Vashi, A.A., and others. (2019, August 7). Identification of emergency care-sensitive conditions and characteristics of emergency department utilization. JAMA Network Open, 2(8).  Click here for free full text:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2747479 Posted by AHA Resource Center (312) 422-2003 rc@aha.org

Downsize the ED and couple it with a PACE unit

Virginia Mason Medical Center (Seattle) opened a new emergency department in November 2011 with 17 beds — smaller than the hospital’s old ED.  However, the new department is adjacent to an 18-bed Patient Accelerated Care Environment (PACE).  The hospital found that there is less need for a fast-track area in the ED and more need for a place where patients can be accommodated for a few hours — those who will not be admitted, those who are being prepped for admission, as well as those who are in the discharge process.  The hospital has found that 35 to 40 percent of ED patients are transferred to the PACE unit

Source: New ‘patient accelerated care environment’ aims to facilitate work flow, free up ED for acute care needs.  ED Management;24(2):17-19, Feb. 2012.  Click here for publisher’s website: http://www.ahcmedia.com/public/products/ED-Management.html  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Chest pain patients = 12 percent of ED patients at one AMC

Three hospitals with chest pain units are profiled in this news article.  Shands Critical Care Center (Gainesville, FL), at the University of Florida sees 75,000 ED patients annually, of which 9,000 (12 percent) present with chest pain.  Previously, low-risk and moderate-risk chest pain patients were admitted to the hospital for observation.  In late summer 2011, Shands opened an 8-bed chest pain unit in the main emergency department.  The unit immediately resulted in a decrease in the number of  observation admissions — to about 10 percent of the low to moderate risk patients seen in the chest pain unit.  Two other hospitals are also profiled: Rhode Island Hospital and Palmetto Health Richland (Columbia, SC).

Source: Chest pain units help EDs streamline care, boost throughput for low- to moderate-risk patients.  ED Management;23(11):125-127, Nov. 2011.  Click here for subscription information: http://www.ahcmedia.com/public/products/ED-Management.html  Posted by AHA Resource Center, (312) 422-2050), rc@aha.org