How Patients With Primary Care Needs Impact ED Management

Numerous studies conducted over the last decade have investigated the question of why consumers without GPs turn to the local emergency department (ED) for routine, primary care. Research has uncovered a number of things that the healthcare community has tried to address. They will not be discussed here. Instead, the main topic for this post is the impact patients with primary care needs have on  ED management.

America’s EDs can be difficult beasts to tame even under the best of circumstances. But when EDs are forced to manage a large volume of non-emergency situations, any semblance of control can go right out the window. Therefore, it’s important for administrators and ED clinicians to understand the profound impacts of providing primary care in an emergency environment.

The 7 Biggest Impacts

Patients seeking primary care directly impact ED management in countless ways. Listing all of them would be nearly impossible in a single post. So instead, let’s focus on the seven biggest and most profound impacts:

1. Patient Volume – EDs have been reporting for more than a decade that primary care cases have significantly increased patient volume. As patient volume increases, resources are strained.
2. Resource Allocation – ED management relies heavily on adequate resource allocation to manage both acute and non-urgent cases. When non-urgent cases are exceptionally high, resource allocation for acute cases sufferers.
3. Overcrowding – It is not unusual for America’s EDs to report overcrowding during those peak times when primary care seekers visit in large numbers. Overcrowding negatively impacts both quality of care and ED management capabilities.
4. Wait Times – Common sense dictates that heavier patient volumes increase wait times. Therefore, wait times for acute cases go up as the number of patients seeking primary care increases. This could create a potentially dangerous situation for acute patients arriving later in the day.
5. Fragmented Care – Using the ED to provide primary care can result in fragmented healthcare delivery. Fragmentation is exacerbated by a lack of communication among staff.
6. Poor Continuity – It’s very difficult to provide continuity of care for patients who use the ED for primary care needs. Such patients are not helped by this reality.
7. Increased Admissions – High volumes of primary care patients can lead to higher admission rates simply because ED staff need to free up beds. This puts further strain on ED administrators to better control admissions.

There may be a number of valid reasons for utilizing the local emergency department for primary care. Nonetheless, EDs are not equipped to handle primary care. It is not their purpose; it is not their mission. When an ED is forced to invest too much in primary care, ED management is considerably more difficult.

Practical Solutions to Start Working On

SouthlandMD is just one of many service providers capable of working with hospitals to improve ED management. But our services alone cannot solve the problem of some patients utilizing the local ED for primary care. What can healthcare do as a community and industry? Here are some practical solutions:

• Increasing access to affordable primary care.
• Implementing limited primary care interventions in the ED.
• Improving care coordination among healthcare providers.
• Aggressively promoting primary care is a specialty.
• Educating patients about the impacts of running to the Ed for primary care.

The typical patient means no harm when seeking primary care at the ED. By and large, consumers barely understand how our healthcare system works. Their confusion is part of the problem. At the same time, a consumer’s decision to seek primary care at an ED only contributes to a bad situation. ED management only goes so far toward solving the problem.