ER to acute care coordination

With a growing focus on continuity of care across settings, the Hospital Corporation of America North Texas Division (HCA) and First Choice Emergency Room, a freestanding emergency room system, have formed a partnership to increase access in Dallas-Ft. Worth region.
The Hospital and Emergency Care Alliance was created to improve patient continuity of care through multiple access points for emergency services and to also help to reduce avoidable emergency department visits in hospitals. 
“The alliance will enhance patient care by expediting hospital transfers, fostering communication between doctors and, ultimately, ensuring a continuum of care for patients from First Choice Emergency Room to HCA’s 5,000 physicians and 11 local hospitals,” said Graham Cherrington, First Choice chief operating officer.
First Choice has 17 facilities that provide 24-hour access, five of them in the Dallas/Ft. Worth area. HCA has hospitals, ambulatory surgery centers, imaging centers, and two freestanding emergency rooms in the region. Both plan to add facilities in the area.
The two organizations will work more closely on education efforts in the communities they both serve “to build awareness of the multiple access points for emergency care and facilitating communications among our doctors,” Cherrington said.
The partnership will also create a joint quality assurance process and team to collaborate and support ongoing quality assurance programs related to the transfer of patients between facilities and sites.
The team will establish metrics to assure quality outcomes that meet with national benchmarks for emergency services and any new measures put in place for freestanding emergency departments, according to Mark Whitley, senior vice president planning and development, HCA North Texas Division. The two organizations will have a mutual goal “to inform patients, consumers and providers on the various access points along the healthcare continuum including urgent care, freestanding ERs, and hospital ERs,” he said. 
By having more emergency services available in the community instead of relying on more expensive hospital emergency departments, the agreement assures bed availability for patients who need acute care services provided by HCA’s network of hospitals.
As part of the partnership, First Choice ER can transfer its patients to a nearby HCA facility. Patients transferring from First Choice ER will bypass the hospital’s emergency department when non-emergency criteria are met and can be directly admitted. 
First Choice ER will have access to the HCA Transfer Center, a 24/7 call center to coordinate patient transfers for hospital admission. The Transfer Center also provides access to teams for high-risk obstetrical care, neonatal intensive care and pediatrics.
First Choice ER clinicians, who are board-certified emergency physicians and emergency-trained registered nurses, will be able to consult with HCA physicians and accelerate subsequent communications with the accepting hospital to get the needed patient care. 
As the quality assurance team evolves, it may add new IT tools or identify new ways to best work together, Cherrington said.
First Choice is an example of freestanding emergency rooms and urgent care centers that can handle flu to broken bones and are a growth business in healthcare, especially in areas attracting more population, like Texas.
Freestanding treatment facilities are increasing also in anticipation of the need for wider access under healthcare reform and to lower costs, according to research from Kalorama Information. 
These facilities reduce some of the primary care visits sought by the uninsured at hospital emergency departments or offer longer hours for patients and families than physician practices, said Bruce Carlson, Kalorama’s publisher.
“With so much focus on the hospital and the physician waiting room, many have ignored this under-the-radar healthcare revolution that has been going on,” he said in an announcement of the recently-released the report, “The U.S. Market for Urgent Care Centers.” The number of these facilities has expanded from 8,000 in 2008 to 9,300 in 2012.