EL: Absolutely. Leadership and education are critical. Surgeons should be educated to appreciate the benefits of this intervention. The third reason is that in order to accomplish smoothing, hospitals should do pretty intense data analysis. Not all hospitals have these resources, and the government should do its job to invest in hospitals getting the necessary technical support. Last but not least, I think emergency physicians must do a better job of explaining to the public the real cause of overcrowding and boarding. No matter what you do in your emergency department—and I am not suggesting that emergency departments are flawless—you alone cannot resolve overcrowding. That message should be known by the public.
Explore This IssueACEP Now: Vol 35 – No 11 – November 2016
PV: What would happen nationwide from implementing this intervention?
EL: The return on investment would be huge. In 2012, two leading US health policy experts, Dr. Arnold Milstein and Dr. Stephen Shortell, in their piece “Innovations in Care Delivery to Slow Growth of US Health Spending” in the Journal of the American Medical Association, estimated that national diffusion of patient-flow optimization—optimally managing patient demand and health care capacity—has the potential to reduce total US per capita spending by 4 percent to 5 percent, which is $120–$150 billion a year. This intervention does not require capital investments. Quite the contrary, hospitals that implemented this approach saved millions of dollars and many human lives.