Emergency departments in the U.S. have seen a steady increase in patient volumes, causing delays and overcrowding.
In the past, wait times to see a healthcare professional in ERs could last from several hours to more than half a day.
This affects patient outcomes and hospital work.
Data from Memorial Hermann Memorial City Medical Center in Houston shows that average wait times to see a doctor were as long as 93 minutes before new strategies were used.
Some patients even left without getting care.
By 2006, the national average ER wait times rose from 38 minutes in 1997 to 56 minutes.
One reason for these delays is many patients visiting the ER for problems that are not urgent.<\/p>\n
To give faster care, some hospitals like Memorial Hermann Memorial City Medical Center use a “quick look” method.
This means a nurse or healthcare worker looks at each patient within five minutes of arrival.
They quickly check if the problem is not an emergency so the patient can be treated quickly or sent somewhere else.
This strategy improved care times.
At Memorial City, the time from arrival to initial triage dropped from 13 minutes to around three minutes.
The wait to see a doctor fell from 93 minutes to 20 minutes.
Also, fewer patients left without being seen, dropping from 10% to 2%.
This helped patients and hospital staff.
Complaints about delays went down to just a few per month.
Dr. Jorge Trujillo said this helps doctors focus on very sick patients while quickly dealing with less urgent cases.
However, this does not fix hospital bed shortages for admitted patients, which also cause ER crowding.<\/p>\n
Urgent care centers (UCCs) have grown quickly in the United States, now nearly 9,000 in number.
These centers provide walk-in care for minor illnesses like ear infections, flu, strep throat, sprains, and small cuts.
They usually work outside hospital ERs and have longer hours than many regular doctors.
This is important because 60% of patients with primary care doctors say their offices do not offer evening or weekend care.
Urgent care centers do not treat serious or trauma cases or admit patients to hospitals.
They focus on quick evaluation and treatment of minor problems to lessen ER crowding.
Centers connected to hospitals can share health records to improve care.
But the effect of urgent care centers on overall healthcare costs is mixed.
Some studies show while they reduce ER visits, they may increase total healthcare spending by leading to more visits and hospital admissions.
For example, in Medicare patients, opening a UCC raised yearly spending by $268 per person.
Six years after a UCC opens, about 4.2% of Medicare users in that area use it, and half of the extra costs come from more hospital stays.
Urgent care centers are more common in suburban and wealthier areas where patients have private insurance or Medicare.
Poorer or inner-city areas have fewer urgent care centers, so they still use ERs more often.<\/p>\n
Another way to reduce ER crowding is to put urgent care inside hospitals.
New York City Health + Hospitals created ExpressCare clinics inside public hospitals like Elmhurst, Lincoln, and Jacobi.
These clinics treat non-life-threatening issues such as colds, flu, minor injuries, skin infections, and urinary tract infections.
ExpressCare clinics are open year-round, allow walk-ins, and have longer hours during busy ER times.
They accept most insurance plans and offer financial help for uninsured patients.
By sending many low-need patients to ExpressCare instead of the ER, wait times and crowding have gone down a lot.
Patients often get care in under 30 minutes and leave within an hour, instead of waiting many hours in the ER.
Unlike separate urgent care centers, ExpressCare keeps patients connected to primary care providers in the Health + Hospitals network.
This helps avoid broken care and supports long-term health.
Dr. Mitchell Katz, president and CEO of NYC Health + Hospitals, says that giving \u201cthe right care, at the right place, and at the right time\u201d improves access and efficiency.
The program cost $1.5 to $2 million per clinic.
Community leaders and hospital staff have said it improves patient experience and helps hospital finances.<\/p>\n
Even though these alternative care models help, problems remain.
Having doctors involved early in triage can improve care but costs a lot.
Some hospitals stopped these approaches because they could not afford to keep paying without more funding.
Urgent care centers lower ER load in some ways but may add to healthcare costs by causing more hospital admissions.
Care can be duplicated, records can be fragmented, and patients might get confused about when to use urgent care versus regular doctors.
Also, urgent care centers are unevenly located.
Inner-city and rural areas usually have fewer urgent care centers, so people there still use ERs for conditions that could be treated outside.
Hospitals have to consider how redirecting patients might affect their income.
ER visits bring in important money for hospitals, so lowering unnecessary visits can hurt hospital finances.<\/p>\n
Besides changing how patients get care, technology like artificial intelligence (AI) and automation can help reduce ER crowding and improve hospital work.
Many hospitals get many calls and questions that can overwhelm staff.
AI phone systems can answer questions and schedule appointments 24\/7 without human help.
These systems also help guide patients to the right place based on their symptoms, which can lower ER visits.
AI tools linked to health records can track patient flow and wait times.
This helps staff send resources where they are needed and find high-risk patients sooner.
Automated check-in and registration reduce mistakes from manual entry.
Less paperwork gives medical staff more time to care for patients and lessens delays during busy times.
For hospital leaders and IT managers, investing in AI tools supports goals of better access and smoother work.
These technologies work well with clinical care improvements to help with ER crowding and urgent care demand.<\/p>\n
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