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ED Care Landscape: 2023 Data Shows Crowding Problems are Worse than Ever

April 27, 2023

ED Benchmarking Alliance Data Suggests Need for a New Approach

Emergency departments have long faced the problem of overcrowding, but during the COVID-19 pandemic volumes dropped precipitously. The use of alternative care models, including virtual care using telemedicine, skyrocketed. But ED Benchmarking Alliance data presented by Dr. Jim Augustine at the recent Solutions Summit meeting of the Emergency Department Practice Management Association showed emergency encounter volumes have rebounded to new record levels and wait times and crowding have become worse than ever.

‍Some highlights from Dr. Augustine’s presentation include:

1.  Overall emergency department volumes have rebounded to new record levels, with 155 million visits in 2022 and a projected 160 million visits in 2023. Because of the unavoidable demographic pressures caused by the aging baby boomer generation, visits are expected to reach 180 million visits by 2028. About 80% of these patients arrive as “walk-ins” with about 20% arriving by pre-hospital Emergency Medical Services (EMS). ED patients that then get admitted account for over 65% of hospital inpatient stays across the country.

2. The marked decrease in available staff, particularly nurses, has resulted in many inpatient beds being unavailable to emergency patients requiring admission for inpatient care. These patients spend prolonged periods of time “boarding” in the emergency department, which in turn reduces the number of treatment rooms available for new emergency patients. The end result is patient flow is awful, creating increased stress for both patients and staff.

3. The ED Median Boarding Time increased from 121 minutes in 2020 to 192 minutes in 2022 and is trending even higher in 2023. It is not uncommon for high volume EDs to average 50 or more boarding patients in their emergency department. The number of patients that leave emergency departments before treatment is complete has more than doubled in the past 4 years, to the highest level ever at 4.6% in 2022. And again, this metric is trending even higher in 2023.

Across the U.S. this year, over 7 million patients will become so frustrated with waiting they will leave the emergency department before their treatment is complete.

Moving Forward With Technology

The staffing shortage that underlies these emergency patient flow issues is a problem that will not be solved in the short term. So the situation demands new approaches to care, and leveraging technology can play an important role.

EmOpti has unmatched expertise in the deployment of hybrid virtual care models, whereby virtual personnel collaborate in real time with on-site personnel to improve workflows. Ultimately, we believe every patient care area will include a “video portal” used for multiple purposes by multiple virtual provider personnel. Whether the initial focus is virtual nursing, tele-triage, virtual oversight, virtual rounding, or any of a number of other use cases, EmOpti is ready to help determine how telehealth care models can positively affect your emergency department. Our experience and insights can help identify the highest-impact opportunities, and our award-winning purposefully designed software can be deployed to support new processes. Contact our experts to learn more or to request a demo.


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