One-third of US residents have sought ED care recently. What did they think?

'You have to have a place to go, and the hours have to reflect the life of people'

Many U.S. residents who have recently sought care at an ED cite frustration with the quality and cost of the care they received, according to a recent poll by NPR, the Robert Wood Johnson Foundation, and the Harvard T. H. Chan School of Public Health, Abe Aboraya writes for NPR's "Shots."

Up to one-third of U.S. residents have sought care in an ED in the last two years, the poll found.

Why the ED?

EDs are set up to treat life-threatening emergencies. But 47 percent of poll respondents said they opted for ED care to treat non-urgent health issues. They go to the ED out of convenience, says Robert Blendon, a professor of health policy and political analysis at Harvard's T.H. Chan School of Public Health.

According to the poll:

  • 28 percent of respondents chose the ED over a visit to a doctor's office, urgent care facility, or community health clinic because those facilities were closed at the time or had no appointments available; and
  • 3 percent of respondents chose the ED because of the distance they'd have to travel to the other facilities.

Blendon says it's a misconception that all patients who go to the ED for non-urgent care are uninsured, have low incomes, or lack a PCP. For example, 80 percent of respondents from Florida who had been to an ED are insured.

But any effort to shift non-urgent cases from the ED could require help from the rest of the medical community. It would help, Blendon says, if community doctors were more accessible during evenings and weekends. "You have to have a place to go, and the hours have to reflect the life of people," he says.

Tailoring services to specific populations

But what if hospitals don't want to lose ED patients to other providers?

To make patients' ED experience more convenient, some EDs are letting patients schedule their appointments.

Other efforts include tailoring their care and facilities to certain groups of patients. For example, Nemours Children's Hospital in Orlando, Florida, has a brightly painted waiting room with seating that appeals to children, and its ED offers no-cost slushies. In addition, a sign notes, "REACH: Respecting Each Awesome Child Here."

Delilah Torres, a mother of a 10-year-old son with Down syndrome, notes that she appreciates the attention the hospital gives to children. She notes that while it usually takes four nurses to draw blood from her son, at Nemours, "it actually only took two."

A friendly approach can make itself evident on patient satisfaction scores, Harwell notes (Aboraya, "Shots," NPR/WFME, 3/10).

Patient access: More than just getting an appointment

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In this video, Southwind's Ayal Bitton shares what his own experiences taught him about the importance of having a robust patient access strategy, and shares three strategies for managing the challenge.

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