Dr. Cedric Dark (320x240)
Dr. Cedric Dark, assistant professor of emergency medicine at Baylor

In the realm of emergency care, minutes matter. A recent multi-institution study, including Baylor College of Medicine, seeks to evaluate and compare standard emergency department metrics and patient satisfaction scores at freestanding emergency departments (FEDs) affiliated with academic institutions against national emergency department (ED) averages. The study appears in The American Journal of Emergency Medicine.

Evaluable metrics included patient satisfaction, treatment times, wait times and patient acuity data. The analysis was conducted across eight academic freestanding emergency departments: three affiliated with Baylor, three from Cleveland Clinic, one from the University of Utah and one from Northwell Health at Hofstra University.

“We wanted to incorporate several institutions in this study to better understand how FEDs across the country compare to national hospital-based emergency department averages”, said Dr. Cedric Dark, assistant professor of emergency medicine at Baylor. “The standard ED quality metrics we analyzed are commonly used in the field, easily comparable and trackable across sites, and relevant to ED operators.”

The patient satisfaction scores that were evaluated from the FEDs were higher than the national average, scoring in the 91st percentile as opposed to the 50th, as scored by the Press Ganey system. These higher patient satisfaction ratings are impacted by factors such as wait time, time with the physician, quality of care and facility, and staff attentiveness.

“The freestanding emergency departments in our study group offer a great value proposition, as they have similar treatment times to traditional EDs, but offer higher patient satisfaction,” said Dr. John Dayton, lead author of the study and assistant professor at the University of Utah.

In this study, the percentage of people who left the facility without being seen by a physician was 0.4 percent in freestanding emergency departments, compared to 2.1 percent at hospital-based emergency departments.

“It was interesting to see that, in our study, the number of patients who left without being seen by a physician was much lower in freestanding emergency departments compared to hospital-based emergency departments, which is likely attributed to lower wait times experienced at FEDs,” said co-author Dr. Erin Simon, emergency medicine physician and research director at Cleveland Clinic Akron General and Associate Professor at Northeast Ohio Medical University.

Freestanding emergency departments saw a much higher percentage of triage level 3 (urgent) and 4 (semi-urgent) patients compared to hospital-based emergency departments, indicating that 10 to 14 percent more patients are seeking care in freestanding emergency departments for urgent and semi-urgent conditions. These patients need workup and evaluation of some kind in order to make a diagnosis, but may not require hospital admittance.

“I hope the results of our study encourage more freestanding emergency departments to share their metrics so we can continue this research on a larger scale,” Dark said. “We want to know what these metrics look like across the nation so there is some kind of standard that institutions can hold themselves to.”