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Free-standing ERs to bring medicine to rural areas

Case Management Weekly, January 14, 2004

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Under political pressure to bring public medicine to its western suburbs, the North Broward Hospital District in Florida is close to opening a stand-alone emergency room. Running an ER outside of a hospital is being tried in two Florida towns and in a few areas across the nation, but the idea is generating controversy with critics saying such a facility remains unproven and could endanger patients.

A free-standing ER would have the same caliber of doctors, nurses, and equipment as a hospital ER, but without backup from operating rooms, intensive care units, in-house specialists or other services crucial in emergencies. Patients could not be kept more than 23 hours.

The tax-assisted hospital district estimates that 25,000 patients per year would use the free-standing ER. The district's plan is to transfer serious ER patients to Coral Springs -- about six miles to the north.

Officials from the district, the state, and the hospital industry said the free-standing ER is a coming trend. ER doctors and ambulance crews would decide in advance which types of patients go straight to a hospital, and ER physicians would be trained in how to transfer patients.

Most other states allow stand-alone ERs, but a few banned them. California forbids hospitals from calling free-standing facilities emergency rooms, on the grounds the public might be misled.

Adapted from the South Florida Sun-Sentinel

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