New HealthLeaders Media Survey Presents a Wake-Up Call for America’s EDs

Press Releases, May 15, 2014

65% of healthcare leaders expect ED volumes to increase in the next three years, but admit that patient flow and boarding continue to be two of their greatest challenges. Will the industry discover a long-term strategic solution before conditions worsen?

A new independent HealthLeaders Media survey, The ED Fix: Triage, Coordination, and Navigation, supported by TeleTracking Technologies, Inc., uncovers emerging best practices in care team composition and patient flow to improve ED throughput and patient satisfaction. The research is based on data drawn from the 7,000-member HealthLeaders Media Council, plus independent expert analysis. It is available for free download now at

Among the findings of this exclusive survey: 71% of respondents from large organizations (with net patient revenue of $1 billion or more) say their ED is always or often overcrowded. Among those organizations, the average time patients spend in the ED before being seen by a healthcare professional is 46 minutes.

Peter P. Semczuk, DDS, MPH, vice president of clinical services at Bronx, N.Y.–based Montefiore Medical Center, admits this is of great concern for ED leaders, “One of the things that keeps me up at night, that’s absolutely top of mind, that I worry about all the time, is patients that are left in the waiting room. It really frightens me because bad things happen to patients in waiting rooms. We want you inside, around the clinical team that’s caring for you.”

One potential solution for decreasing bottlenecks and increasing efficiency is to begin the triage process in the waiting room, including streamlined registration and channeling low-acuity patients to a fast-track area. Leaders also recognize the importance of preemptive discharge planning. To make room for more ED patients when inpatient occupancy is high, Texas Health Harris Methodist Hospital Fort Worth admits certain patients who then occupy screened-off hallway beds to expedite transfer.

“That way we can get a patient out of the emergency department and take them up to the floor until a bed opens up,” explains Joseph S. Prosser, MD, MBA, CPE, FACPE, Vice President and Chief Medical Officer of the hospital. “The patients actually want to do that—they want to get out of the emergency room and upstairs in the hospital where they’re being managed by nurses and staff that are familiar with their pathophysiology.”

Healthcare leaders are also focused on fostering efficient throughput by minimizing the number of non-emergent patients who visit EDs. At the top of the list of tactics to minimizing avoidable ED visits is limiting prescriptions for opioids, tracking patients who visit EDs seeking opioid prescriptions, and improving coordination with primary care practices and clinics.

Financial investment may be a critical factor in improving outcomes. Overall, 40% of survey respondents expect to make ED-related IT investments over the next three years, which may include EHRs, telemedicine infrastructure, and capacity management systems. According to Nanne Finis, RN, MS, Vice President of Consulting Services at TeleTracking, the report sponsor, nearly 900 of the nation’s 5,000 hospitals already have installed real-time, systemwide automated control systems to expedite patient movement, identify open beds, find medical equipment, and avoid flow bottlenecks.

Other compelling statistics from the survey include:

  • Streamlined registration (63%) and channeling low-acuity patients to a fast-track area (65%) are leading techniques for increasing ED throughput.
  • More than half (53%) of respondents will have a program to redirect non-emergent patients within three years.
  • Nearly half (46%) of respondents expect to invest in midlevel caregivers for their EDs within the next three years.
  • IT (40%) and telemedicine (36%) are among the top ED investments.
  • More than half (54%) of respondents are minimizing avoidable ED visits through better coordination with primary care and clinics.

In light of these statistics, Finis believes change is happening not a minute too soon. “With waves of aging baby boomers and the newly insured advancing on the nation’s EDs, it’s time for a wake-up call. We sincerely hope this survey helps to initiate that call.”

In addition to the complimentary report, two extended versions are available for purchase, containing in-depth analysis and additional features: the Premium version, available for purchase at, includes data segmentation, meeting guides, and three case studies featuring initiatives by Presbyterian Healthcare Services in Albuquerque, N.M., Texas Health Harris Methodist Hospital Fort Worth, and Montefiore Health System in Bronx, N.Y; and the Buying Power version, available for purchase at, which is designed for healthcare industry suppliers and includes detailed drill-down data on purchasing trends and projections to aid sales strategies.

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