Editorial
A room with a view: On-call specialist panels and other health policy challenges in the emergency department

https://doi.org/10.1067/mem.2001.115174Get rights and content

Abstract

[Asplin BR, Knopp RK. A room with a view: on-call specialist panels and other health policy challenges in the emergency department. Ann Emerg Med. May 2001;37:500-503.]

Section snippets

A visit to the emergency department

Paramedics respond to a 911 call for a patient with a head injury. They initiate appropriate treatment and begin transport; however, they soon learn that the destination hospital’s ED is “on divert,” forcing them to transport the patient to the city’s only remaining open ED. This requires an additional 15-minute transport, and the ambulance is out of its service area for an extra 45 minutes.

In the ED, paramedics note the long row of gurneys in the hallway, signaling that this ED may soon need

Converging health policy challenges

This case vignette is no longer shocking for most emergency physicians. After all, there was no dramatic adverse patient outcome, and problems with ED overcrowding have become so familiar that the struggle to find inpatient beds is part of our daily routine. Waiting hours or even days in the ED for an inpatient bed, however, is still shocking to our patients. In some EDs, a 7-hour stay in the department awaiting ICU admission would be cause for celebration. In others, it would be a disaster.

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