Author: Betsie Sassen, R.N., M.S.N.
During COVID-19, volume in Emergency Departments across America have decreased by as much as 25-30% in some cases. The volume that has been lost is mainly lower acuity patients that found another alternative such as Urgent Care, Acute Care Clinics, or even Tele-Health. As these patients have been slowly transitioning away over the years, COVID-19 brought an abrupt halt to this type of volume coming to the Emergency Departments. These new avenues are not going away. The remaining patients are maintaining the higher acuity, and at times, even higher. In fact, our clients are reporting that while there has been a drop in volume, there has been a rise in level charges.
The challenge many are facing today is how do we look at our current standards knowing that the department “DNA” has changed. Yes, we should be adjusting our staffing down as closely as we can to the existing standard, however, do we need to re-evaluate what that standard makeup is? Is there a need for us to re-model our grids and the projected volume knowing that the average patient is carrying a higher level of care? Our advice is to reset and determine the new level of care just as if a Medical Surgical Unit switched to an Intermediate Care Unit. In that case, you would change your targets and adjust your staffing. This does not mean there are not improvements that are to be made with the volume drop, rather, the totality of the improvement might be inflated until the target has been readjusted. This is also important because many Emergency Departments have started using outside agency and higher incentive pay to compensate during the COVID-19. This needs to be cleaned up, cleaned out, and an affordable yet high quality Emergency Department must be restored.
We can help.