July 20th, 2023

Three things to help address ED Overcrowding: Part 2

Stephanie Frisch
Written byStephanie FrischDirector of Nursing

This is the second installment of a two-part blog series. Read part 1 here.

Hospital leaders, providers, and clinical staff know all too well that overcrowded emergency departments have a negative impact on key metrics like elopement rates, patient experience scores, and community reputation. 

The care team themselves are the most immediate casualties of overcrowding, leaving them feeling burned out and unengaged with frequent call-outs, and attrition. While these are problems that have always plagued EDs, they are becoming even more prevalent across the country.

There are many reasons for ED overcrowding, many of which are beyond the control of the ED itself. But there are things you can do to mitigate the effect on patient experience, regardless of how busy your ED is. In my first installment of this blog series, I shared three observations based on millions of patient interactions facilitated by our ERAdvisor platform. They included:

  • Patients should be communicated to about their wait times

  • Feedback needs to happen in the moment

  • Aligning customer service and clinical quality is paramount, as they are often conflated in the patient’s mind

Fast Facts

  • 90% of EDs are stressed beyond the breaking point at least some of the time.

  • ED occupancy rate is significantly associated with reduced patient satisfaction.

  • The average ED wait time by state is 1.5 hrs to 3.5 hrs.

Three more important observations for crowded EDs

In this second installment, I’d like to share three more observations about ED overcrowding, accompanied by some practical ideas for addressing them. 

1. Give patients easier ways to keep their loved ones in the loop

If you’re like me, you got into health care because you care about people. So, I’m sure you have just as much empathy for your patients’ loved ones as you do for them. When your daughter, grandfather, or best friend is in the ED, they want to be kept in the know. Patients have traditionally needed to ask a bunch of questions, type out text messages, or make phone calls to share things like their health progress, lab results, and even discharge instructions. That’s why we’ve been working on family sharing functionality in our solutions; it’s available with just a few taps within a mobile app. The popularity of this feature has surprised even our own product development teams. Currently, 19% of patients who use Vital’s ERAdvisor patient experience platform share these kinds of updates with friends and family. More importantly, it’s safe, it’s secure, and requires far fewer screen taps—a real advantage to patients who are stressed enough as it is.

2. Take advantage of the discharge process

When it comes to patients feeling informed, an overcrowded ED is a big contributor to low patient satisfaction ratings. In fact, a study featured in Academic Emergency Medicine found that over 21% of patients who reported low satisfaction following a visit to an overcrowded ED said they didn’t feel their care team “kept them informed about their treatment.” In addition to the very personal attention clinicians give their patients during discharge, technology can ensure an even greater understanding of next steps. For example, we’ve seen significant utilization from patients on our AI-Powered Video Education, which is able to auto-prescribe video content curated to each patient’s specific condition or medical procedure. Radically simplifying lab results and other highly technical content during and after an ED visit is now possible using  large language models (LLMs), which have reduced the gap between medical jargon and patient understanding in the use of Vital’s technology.

The value of features like these cannot be underestimated when you consider that 36% of adults in the U.S. have low health literacy—a skill the CDC defines as the “...ability to find, understand, and use information and services to inform health-related decisions and actions…”. It’s a great feeling when you know your patients are leaving the ED with a clear and action-oriented plan. And it also feels pretty good knowing that they’re less likely to fall into that 21% cohort of patients who report dissatisfaction due to not being informed about their treatment.

3. Build in feedback loops for a better reputation, internally and externally

An increasing number of patients use online reviews when selecting a provider—72%, in fact, according to a 2022 Healthcare Trends Report. In my first installment of this blog series, I talked about how patients can provide real-time feedback during an ED visit. Formal channels like these can be used in an even more meaningful way by prompting patient action. For example, when a patient rates your service high (e.g., 5 stars), ERAdvisor prompts them to leave a review on Google. And if this is done while they’re still in the ED (i.e., when everything is still fresh in their mind), they might even leave a short testimonial that you may want to repurpose to recognize your team’s good work. More than 50% of hospital admissions—and therefore considerable revenue—originate from the ED. With the right technology, EDs can generate positive internal and external reputation and drive more impact on the hospital’s balance sheet. Here’s an example from a Vital client. In 2021, Dignity Health and its parent, CommonSpirit Health, wanted to ensure patients discharged from the ED received clear instructions and timely reminders to schedule follow-up care with in-network providers. In response to these needs, Vital developed various ways to notify and remind patients about their recommended follow-up care, including in-app scheduling links, text messages sent directly to the patient’s phone, links to scheduling tools or phone numbers based on patient preferences. These processes led to $1.7M in additional reimbursements in 2021 alone and a 3.8x follow-up appointment return on investment.

I hope you found these observations helpful. I know from working in the ED myself that it’s a tough job. But with the right strategies in place for overcrowding, I think many hospitals have an opportunity to help patients feel more in control while helping staff feel more engaged and appreciated.

Learn more

Find out how Vital’s patient experience platform can help you avoid the negative consequences of an overcrowded ED. 

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