Hospitals try for full ERs, with efficiency - Business First of Columbus:

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Their solutions include more observation fast-track units for less-urgent cases and involving doctors earlierf in theintake effort. All three come with upfrontf costs, but emergency physicians say they’ll bring payoffs for hospitala while often reducing bills for patients and In efforts that started a decadw ago or as recentlyas February, , and repor t reducing wait times by an hour or nearly eliminating the phenomenon of patients who leaved in frustration after incurring an intake charge, and sendiny patient satisfaction scores through the Emergency departments have become a prime target for reformersw intent on reducing use of the most expensive entrgy into the health-care system.
But emergency doctor say the efficiency programs are meant to help them handlde increasing volumes thatthey welcome. “The more patients we see, the bette it is for us,” said Dr. Bruce emergency department medical directorfor OhioHealth’se . Hospitals in northeast Ohio are explorintg triage systems to refeer nonemergenciesto urgent-care centers or other clinics, said Tiffanty Himmelreich, a spokeswoman for the . Columbus emergency departmentse are trying to avoidthat approach. A feverr that might be written off as a cold could insteadbe meningitis, and a sore throat can be a symptomj of a life-threatening abscess, said who’s reluctant to turn away anyone.
Reformers oftem paint a picture of patientsa clogging ERs with sniffles and minor A review of 2006 cases bythe found, that 12 percent of cases were even as the volume of visitas climbed. However, emergency departments statewide are reporting more casesz of people showing up because they lost insurance alonh witha job. “Sometimes thesw patients have nowhere elseto go,” said Dr. Mark Moselehy at Ohio State. “We’re open 24/7, and I don’t know of any ambulatorgy care clinics that say Creative approaches to prevent unneedec inpatient stays are positive if theycost less, said Kellgy McGivern, CEO of the insurers trade group.
“Ift can’t be just another way to charge the she said. “That’s what we’re looking for: lower-cosf alternatives in more clinicallyappropriate settings.” Doctorx Hospital broke its record for emergency departmentg volume in March with an average of 205 patients a day. A more typicalp pace is 190. Jones attributed part of the increas to word of mouth since physicians starteds seeing patients in the first minutesa of triagein June.
Before, a patient wouldn’y see a doctor until getting to a bed afte r three tosix Now, even if the wait is sometimes that the doctor can order tests or drugs so pain is controllesd in the interim and treatment begins as soon as a bed openes up. Also, 10 percent to 15 percent of patients can be dischargede straight fromthe lobby, increasing access to the unit’s 24 , a Canton-based practice that staffs Doctors and emergency roomws in nine states, added three full- and thre part-time jobs, including physician assistants and nurse practitionersa to free physicians’ time.
The practicw started the triage physician system a few years ago and is adopting it at all hospitalsxwhere it’s under contract. The practice also is sharingb its methodswith , the practice that staffs OhioHealth’s and Riversids and Dublin Methodist hospitals. At Ohio State’s main a 20-bed Clinical Decision Unit that openesd in Februarycost $1.9 millio n and added about 50 jobs, but couldx result in millions in savings and added revenue, said Moseley, unit medical director. Patientx in the unit stay for up to23 hours. The charge is more than the typicaol emergency room bill but much less than ahospitakl admission.
The new unit also freed six beds for speediet evaluations by doctors in the mainemergencgy department, similar to the program at Mount Carmel has used 23-hour observationb units for about 10 years, said Tammty Weidner, vice president for patient care services at St. Ann’x Hospital in Westerville and the system’s efficiency It also keeps adopting protocolsx to reduce time to diagnosisor treatment, she It’s important to ensure the processw doesn’t get rushed, leading to misses diagnoses or return visits in a few Weidner added. “The more efficient and appropriatedthe care,” she said, “the more cost-effective healthg care is for everyone.
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