Smart Emergency-Care Strategies

How to Get Good Emergency Care

If you're heading to the emergency department, prepare for a long wait and potentially a slew of problems.

A new study from HealthLeaders Media shows that almost half (46%) of healthcare executives say their emergency departments are overcrowded. More than half worry the situation jeopardizes patient safety.

There are lots of reasons for the overcrowding. Hospitals are advertising their emergency departments to compete with other community facilities. (A significant percentage of hospital admissions -- critical to hospital revenue -- come from the emergency department, according to the report).

Now, even doctors on call  often just tell patients to "go to the ER" rather than meeting them in their clinic or office on weekends and off-hours as they once did. And people can't count on urgent care centers since many are closed after 9 p.m. on weekdays and are not open on Sundays. For those without a primary care physician or who work during the day, the emergency department may be their only choice.

The report comes from a survey of about 300 respondents in hospital management, patient care, finance and information technology. Forty-three percent said that re-thinking emergency department "flow" was their biggest strategic challenge. Almost all say they're working to improve their systems, including developing zones for less acute problems.

In the meantime, here's what you can do: If possible, find a primary care provider who takes being on call seriously and doesn't just tell you to go to the emergency department or urgent care center when you phone with a problem in off hours. That may not be easy. If you have a choice of healthcare insurance programs, evaluate the HMO in your area. Some have excellent extended-hours clinics that work efficiently and even include convenient pharmacy services. Especially as you approach the weekend, don't postpone problems that could get worse. Make an appointment with your physician if you can; if you can't, get to urgent care before the weekend. If you're unsure about your problem, know that many health insurance programs have nurses available through a call center. You can ask them, based on your symptoms or concerns, if you need immediate care. Check with your insurance program to see if this service is available. If your problem needs attention but is not an emergency, consider driving a little farther to a hospital if its emergency department has a reputation for better service and shorter waiting times. If your hospital's emergency department offers "appointments," consider using the service. Some charge for it, but it may be worth it to you.
And, without a doubt, if you have any serious health concern, call 9-1-1 or get to the emergency department immediately. Don't let the fear of a crowded waiting room worry you so much that you fail to get the help you need. Barbara Bronson Gray, RN, MN,  is the founder of the blog, which is “dedicated to helping people learn to be the CEO of their own body and better guide their own health care.” Besides her hands-on work as both a nurse and supervisor in hospitals, Barbara has written articles that have been published in a number of national magazines and newspapers. Follow her on Twitter: @bbgrayrn. 
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