outpatient imaging
Introducing a Freestanding
Emergency Department
By Janet Scott, CRA, RT(R)(M)
When most people hear “emergency
room” or “ER” it conjures up memories
of television shows or hours spent with
a sick loved one waiting to be seen by a
doctor. But a growing trend across the
country is changing that.
A freestanding emergency department
(FED) may be foreign to some, but over
the past ten years, it has become a growing trend across the country. According
to the American Hospital Association
and a study for the California Healthcare
Foundation, in 2009 there were a total of
241 FEDs throughout the country in 16
different states. 1 This was an increase of
65% over the previous five years, where
a mere 146 such facilities existed across
the country.
What has led to this increase? Nationwide, emergency departments (EDs) are
being stretched beyond capacity. Despite
our excellent local hospitals, ambulance
diversions still happen and long waits in
the ED are often the norm. Because our
communities are still growing and aging, that need will also continue to grow.
FEDs relieve stress on other hospital-based EDs, provide shorter wait times, on
average, and enable local EMS squads to
deliver their patients locally and return to
service in the community more quickly.
The Center for Disease Control and
Prevention has reported that 32.1% of
ED visits are non-urgent or semi-urgent,
while 36.6% are urgent. 2 This suggests that
68.7% of ED visits could be adequately
cared for in an outpatient, non-emer-gency facility or FED. This, coupled with
patients’ lack of primary care physicians,
FEDs relieve stress on other hospital-based EDs, provide
shorter wait times, on average, and enable local EMS squads
to deliver their patients locally and return to service in the
community more quickly.
results in many choosing the ED as their
sole means of care. FEDs help to fill the
need for increased access to emergent care.
Unlike an urgent care center, which
are typically limited in their hours and
the services they can offer, FEDs are generally open 24/7, staffed by emergency
medicine physicians, receive ambulance
patients, and strive to duplicate the complete complement of radiology and lab
procedures and services offered by hospital EDs. Urgent care clinics generally only
have diagnostic x-ray available, if any imaging is available at all. Healthcare professionals in a FED can stabilize a critical
patient and provide treatment options
for many other emergent situations. For
those patients who need to be transferred
for more in-depth care, there are often
local emergency medical transportation
services on site. In addition to the quality
care received at a FED, patients appreciate the quick door to doctor time and
reduced wait times from what is experienced at hospital-based EDs.
With the strong support of our own
community and referring physicians,
the medical campus that we opened just
three years ago quickly became a desti-
nation for many services. Because of its
growth and success, in less than a month,
we will be opening the first FED in our
region and the first for OhioHealth. In
preparation for this new opening, it was
important at the onset to involve all key
stakeholders with setting expectations
for success. Having everyone at the table
is key as you begin to build a vision and
develop processes. Seeking the input of
the associates who are actually doing the
jobs is also essential. Many of these early
expectations will be looked at again and
again as the department is developed.
•;Patient process flows: As we mapped
out each type of patient encounter,
