Question Hospital emergency departments continue to be used as a source of primary medical care by large numbers of the community’s medically underserved population. What are the implications of this practice for the patients, and on health care costs and quality of care? What would you propose as a means to change this situation?

Question Hospital emergency departments continue to be used as a source of primary medical care by large numbers of the community’s medically underserved population. What are the implications of this practice for the patients, and on health care costs and quality of care? What would you propose as a means to change this situation?

Hospital ED
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Hospital ED
The vast majority of the medically disadvantaged population seeks emergency medical attention for diseases that could be handled in primary care settings. A doctor’s clinic or office could handle 13 percent to 27 percent of emergency room visits in the United States, saving $4.4 billion a year (Enard, 2013). Unneeded ED visits are more costly than being handled in a primary care environment, and the increased cost of unpaid treatment is impacting numerous healthcare facilities (AHQR, 2014). Patients, in my practical experience in the emergency room, abuse the emergency department and therefore ought to be informed on how to utilize it properly. For example, a patient called 911 at 2 a.m. after accidentally hitting his left eye with a tennis ball while playing. Another example is when an individual had their father carried to the emergency department by ambulance because they did not want to face having to clean up their father’s excrement.

This issue, in my opinion, is one that affects both patients and the healthcare sector in general. Patients visit the emergency room for a variety of medical reasons, varying from the ordinary to the life-threatening (Young & Kroth, 2018). The use of the emergency service for non-emergent treatment is linked to higher expenditures and lower efficacy. Because the emergency room is equipped with specialized professionals to handle severe sickness and injuries, it is more costly than ambulatory care (Young & Kroth, 2018). This may raise the client’s out-of-pocket expenditures or be expensive for the medical facility, which must bear the expenditures caused by an uninsured client. Due to the necessity to address life-threatening illnesses, emergency room queues are significantly lengthier. ED congestion is another problem that I have witnessed firsthand. Additionally, individuals with psychiatric problems are presented to the emergency unit, where they remain for longer periods owing to a shortage of psychiatric care facilities in the region. As a result, the emergency room is often diverted, preventing it from providing emergency treatment to those that require it the most. Detrimental effects on patient outcomes relating to patient safety, patient-centeredness, treatment efficiency, timeliness, efficacy, and evenhandedness have also been reported as an outcome of ED overcrowding (Tsai et al., 2018).
This issue has the following possible solutions. The first step is to increase primary care accessibility, with a stronger emphasis on preventative care. Numerous emergency department visits associated with primary care are likely avoidable and manageable illnesses in a primary care context (Enard et al., 2013). People without health insurance may be provided with free consultations in order to have access to primary care and preventative care interventions. Employing a patient navigator is one thing we began implementing in our emergency department to decrease diversion. The patient navigator’s job is to assist and guide clients in the emergency department by determining if they have a primary care provider and making necessary referrals if they do not, assisting clients by giving details about the easily accessible resources as well as how to make use of them, and educating patients and their families about the great significance of primary and preventative care. We have observed some progress and therefore this is a step in the right direction. We believe that these quality improvement efforts will assist us in resolving concerns in the emergency department, allowing us to concentrate on delivering high-quality treatment to our clients when they are in need.

References
Agency for Healthcare Research and Quality (AHQR). (2014). Connecting Underserved Patients to Primary Care After Emergency Department Visits. Retrieved from https://innovations.ahrq.gov/perspectives/connecting-underserved-patients-primary-careafter-emergency-department-visits
Enard, K. R. (2013). “Reducing Preventable Emergency Department Utilization and Costs by Using Community Health Workers as Patient Navigators”. Journal of Healthcare Management, 58(6): 412-428.
Tsai, M.-H., Xirasagar, S., Carroll, S., Bryan, C. S., Gallagher, P. J., Davis, K., & Jauch, E. C. (2018). Reducing High-Users’ Visits to the Emergency Department by a Primary Care Intervention for the Uninsured: A Retrospective Study. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 55.
Young, K., & Kroth, P. (2018). Health Care USA (Ninth). Burlington, MA: Jones & Bartlett Learning.