Hospital emergency department
A city fire department offers on-the-scene video consultants between emergency physicians and non-emergent 911 callers, leading to fewer unnecessary ambulance transports and emergency department visits, lower costs, more connections of patients to primary care medical homes, and more time for ambulance crews to deal with true emergencies.
Children's National Health System has an emergency department–based clinic that serves low-income, minority children and teenagers with asthma.
California legislation enhances access to affordable care by limiting the amount hospitals can collect from low- and moderate-income patients who are uninsured or lack adequate coverage and hence face high out-of-pocket medical expenses.
Massachusetts banned ambulance diversions and helped hospitals respond to the ban by improving patient flow, leading to reductions in emergency department length of stay for admitted patients, shorter turnaround times for ambulances, and strong support from emergency department leaders who believe the ban has yielded multiple benefits.
An emergency department uses an eight-variable risk assessment tool to determine which patients should be tested for undiagnosed HIV, leading to the identification of the same number of HIV-positive patients as through universal screening, thus suggesting greater cost-effectiveness.
Emergency department and urgent care physicians and nurses use a protocol to help them decide how to treat patients complaining of pain who may be abusing controlled substances, leading to significantly fewer such patients receiving prescriptions for opioids.
Through a statewide telemedicine program, psychiatrists evaluate patients with mental health issues who present at rural hospital emergency departments, leading to reductions in wait times, inpatient admissions, and costs; increased attendance at followup visits; and high levels of patient and clinician satisfaction.
Emergency department clinicians and staff identify veterans at moderate risk of suicide, work with them to develop a safety plan, and follow up after discharge to ensure adherence to the plan and connections to community-based support, leading to better access to outpatient mental health services.
A safety-net hospital enhances access to timely specialist care by revamping its critical results reporting system to immediately notify surgical oncologists of imaging results that suggest a possible gastrointestinal malignancy.
A five-question electronic survey given to emergency department patients identifies a high proportion with potential eating disorders, suggesting the potential for the emergency department to be an effective venue for early diagnosis and connections to community-based treatment and support.