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Free-Standing ER's

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Interesting concept. I'm going to be interested to see how this works...

http://austin.bizjournals.com/austin/stories/2010/03/29/daily47.html

St. David's to build stand-alone ER

Austin Business Journal

St. David’s HealthCare is building an emergency-room only facility in West Austin, the only one of its kind in the area

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Just for your info Seth, the City of Schenectady operates something similar to this idea. In Schenectady, the two main hospitals are Ellis Hospital (the main facility featuring an ED, ICU, inpatient beds, surgery, etc.) and Ellis Health Center, a 14-15 bed ER that is attached to a medical facility that does scheduled surgeries, wound care, CT scans, but does NOT have inpatient admission capability or a surgical team always on call. Like its said in the article, its a novel idea for alleviating the main ED of the minor sprains and sutures, but we always have the problem of having to transport the walk-in STEMI and stabbing victims to either Albany Medical Center or the main Ellis campus for adequate treatment. Needless to say, some people wonder when the ambulance shows up priority 1 to the back bay of a hospital to pick up a patient, but its worked here for years. Hope this helps a little bit.

Edited by nwpfdjr27

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So, its a walk in clinic with a lab and CT?

Plus, EMS will be able to transport certain patients to this ED. It can provide services that only an ED can in the State Of Texas. The state is very strict with hospital rules. This hospital will also be capable of handling overnight observation patients. It will relieve congestion at the main campus ED, and serve a growing population in the area. It's also an outreach to the population to get new patients into their newtwork.

For instance, a nursing home just here is for basic care. Any patient on a vent, trach, or having specialized ongoing nursing needs goes to an extended care hospital. These hospitals are required to have certain things. For example, I know this one extended care hospital that does mainly vents and patients requiring 24/7 nursing care has a 2 bed full emergency room, not staffed, but the staff on duty at that time can activate it. That's required by law. It's basically mothballed.

Also, we are in a healthcare explosion, with new hospitals being expanded and built all over the place. The freestanding ED this is meant to supplement-that hospital is undergoing a $72 million dollar expansion, and they are also building a brand new multi million dollar hospital near this new freestanding ED.

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Concept is not new. Here where I live in Central Connecticut we have had free standing Emergency Rooms for many years. Middlesex Hospital is the only hospital in Middlesex County. It has a very large emergency room, and one of the busiest in the state but the hospital is at the Northern End of the County. At the southern end of the County, near the shoreline, Middlesex Hospital operates a large, free standing ER which can do pretty much everything that can be done at the hospital's Main ER. To the east of here there isn't another hospital for many miles, so Middlesex Hospital operates a second free standing ER to serve that area. Years ago, when they first opened, the two free standing ER's did not operate around the clock, but for the last several years they have operated 24/7. Ambulances transport emergency patients to the free standing ER's. If a patient needs to be hospitalized, they will be transported to the main hopital after being stabilized in the Free Standing ER. Middlesex Hospital runs a Paramedic Intercept program and operates Paramedic Fly Cars out of the Hospital ER and from the two free standing ER's. Having made use of both the Hospital ER and one of the free standing ER's, I can't tell the difference. They look the same once you are inside, they are staffed the same and equipped the same.

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It's a nice idea, a way to spread out resources...but will be quite taxing on the 911 providers if not done right. In CT, we have the walk-in centers...sorry, it's not a true ER unless they have overnight beds, an OR and the true complement of hospital facilities on site, even if there are ER docs and RN's there. In my PSA, we go there frequently...adding more calls to an overly busy day. When it's closing time, we get called for EVERYTHING, and the volume of needless emergency transports is amazing. It can be done well if there are dedicated private service transport units on site or dedicated to the facility to take out the critical and routine patients.

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