Case Management

Free-standing ERs to bring medicine to rural areas

Case Management Weekly, January 14, 2004

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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