2-Hour Length of Stay in the Emergency Department

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In the ED community there is a new marketing tool—30 minute or less no-wait ED service. The implication is a provider (physician, PA, or NP) will greet you- a la the Wal-Mart greeter- to begin the service relationship. There are billboards, internet advertising, etc. that proclaim your care will be improved because it will be faster.

If properly conducted where the patient is fully evaluated, there should be significant PRC or Press-Ganey score improvements. I would prefer to see the metrics based on speed, quality, and outcome. This would be the “ED Value Plan” that encompasses speed, efficiency, communication, and quality. (9 out of 10 members in my family would choose this plan). The provider will discharge, admit, or carefully discuss with the patient and family the “Battle Plan” for disposition at the 2 hour mark. 1. Discharge prior than 2 hours 2. Admit prior than 2 hours 3. Discussion with patient. a. Outline the timeframe b. Discuss need for more tests (CT abdomen) c. Waiting for consultant d. Providing more treatment to avoid admission (i.e. fluids, 2nd set of troponin levels

XpressTechnologies Electronic Health Record, Practice Management, and Billing Platforms will help the provider reach the patient-centric goal of a rapid but accurate and complete assessment. Being seen quickly to meet a marketing plan does not necessarily lead to better outcomes.

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