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Freestanding Emergency Departments as a Workforce Solution

By Leon C. Adelman, MD, MBA | on September 13, 2022 | 0 Comment
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Health system freestanding ED expansion can help balance emergency physician supply with demand, deliver better experience of care to mid-acuity ED patients, while improving access to emergency medicine across the county.

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Explore This Issue
ACEP Now: Vol 41 – No 09 – September 2022

Disclosures: None. Leon Adelman has no financial connection with Cleveland Clinic or freestanding EDs.


Dr. Adelman is an emergency physician in North Carolina and co-founder/CEO of Ivy Clinicians.

References

  1. The Strategy That Will Fix Health Care. In: Harvard Business Review [Internet]. 1 Oct 2013 [cited 11 May 2022]. Available: https://hbr.org/2013/10/the-strategy-that-will-fix-health-care.
  2. Marco CA, Courtney DM, Ling LJ, et al. The emergency medicine physician workforce: projections for 2030. Ann Emerg Med. 2021;78: 726–737.
  3. Smalley CM, Meldon SW, Simon EL, Muir MR, Delgado F, Fertel BS. Emergency Department Patients Who Leave Before Treatment Is Complete. West J Emerg Med. 2021;22: 148–155.
  4. Dayton JR, Dark CK, Cruzen ES, Simon EL. Acuity, treatment times, and patient experience in Freestanding Emergency Departments affiliated with academic institutions. Am J Emerg Med. 2018;36: 139–141.
  5. Emergency Department Visits. 25 Mar 2022 [cited 11 May 2022]. Available: https://www.cdc.gov/nchs/fastats/emergency-department.htm.
  6. Simon EL, Shakya S, Muir M, Fertel BS. Differences in patient population and length of stay between freestanding and hospital-based emergency departments. Am J Emerg Med. 2019;37: 1738–1742.
  7. Burke RC, Simon EL, Kesav N, et al. Patient-reported reasons for seeking emergency care at a freestanding emergency department compared to a hospital-based ED. Am J Emerg Med. 2018;36(9):1702–1704.
  8. Simon EL, Shakya S, Smalley CM, et al. Same provider, different location: Variation in patient satisfaction scores between freestanding and hospital-based emergency departments. Am J Emerg Med. 2020;38: 968–974.
  9. Alexander AJ, Dark C. Freestanding emergency departments: What is their role in emergency care? Ann Emerg Med. 2019;74: 325–331.
  10. Pines JM. Maybe it’s time to rethink freestanding emergency departments. Academic Emergency Medicine. 2019. pp. 1297–1299. doi:10.1111/acem.13862.
  11. Freestanding Emergency Departments. [cited 11 May 2022]. Available: https://www.acep.org/patient-care/policy-statements/freestanding-emergency-departments/. Accessed August 27, 2022.
  12. Simon EL, Shakya S, Liu L, et al. Comparison of critically ill patients from three freestanding ED’s compared to a tertiary care hospital based ED. Am J Emerg Med. 2019;37(7):1307-1312.
  13. Griffin G, Smalley CM, Fertel BS, et al. Reduced mortality and faster treatment in sepsis seen at freestanding vs. hospital-based emergency departments. Am J Emerg Med. 2022;54: 249–252.
  14. Dark C, Xu Y, Ho V. Freestanding emergency departments preferentially locate in areas with higher household income. Health Aff. 2017;36: 1712–1719.
  15. [No title]. [cited 11 May 2022]. Available: https://www.ruralhealth.us/NRHA/media/Emerge_NRHA/Advocacy/Government%20affairs/2021/04-15-21-NRHA-Rural-Emergency-Hospital-overview.pdf. Accessed August 27, 2022.
  16. How Many Hospitals Might Convert to a Rural Emergency Hospital (REH)? In: Sheps Center [Internet]. 7 Jul 2021 [cited 14 May 2022]. Available: https://www.shepscenter.unc.edu/product/how-many-hospitals-might-convert-to-a-rural-emergency-hospital-reh/. Accessed August 27, 2022.

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Topics: Freestanding Emergency DepartmentsPractice ManagementWorkforce

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