Throughput at freestanding and hospital-based emergency rooms

Healthcare experts are striving to learn about emergency care at freestanding and hospital-based emergency rooms based on different measures of quality care and throughput. A Baylor College of Medicine expert conducted a study on this to investigate how much time patients spend in freestanding emergency rooms compared to hospital-based emergency rooms. The findings were published in the Journal of the American College of Emergency Physicians Open.

Researchers used the Emergency Department Benchmarking Alliance, a preexisting database containing information from hundreds of emergency rooms across the United States. They pulled information from a combined 500 freestanding and low-volume hospital-based emergency rooms and compared metrics on length of stay, door-to-doctor time and how likely one is to be admitted to the hospital.

Findings showed that if a patient was treated and released, their emergency department stay was about nine minutes shorter at a freestanding emergency room compared to a hospital-based emergency department. If the patient was admitted to the hospital, they waited about 44 minutes longer at freestanding emergency departments compared to hospital-based departments.

“If you wind up going to the ER and leaving, it’s more efficient from the standpoint of the patient to do so at a freestanding ER,” said Dr. Cedric Dark, assistant professor of emergency medicine at Baylor and principle investigator of the study. “However, if your condition is sick enough to warrant hospital admission, you will wind up staying in the ER for a bit longer at a freestanding department, because the hospital beds aren’t immediately upstairs. Doctors will have to call hospitals that are open for care and then transfer you from the freestanding ER, which takes up time that otherwise could be spent in your room in a hospital bed.”

Previous research by researchers at Baylor and Rice University determined that freestanding and hospital emergency departments were similar in cost in Texas. According to Dark, further research needs to be conducted to understand more about the quality of care at freestanding emergency rooms.

Other contributors to this work include Maureen Canellas, Caroline Mangira, Nick Jouriles and Erin L. Simon.

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