FHA Task Force on Challenges in the Emergency Department Challenges facing Florida’s Emergency Departments Increased patient volume Sicker patients Increased number of uninsured patients ED staffing – On call coverage Nursing shortage Insufficient ED space Bed shortage
Emergency Department VisitsUnited States1993 - 2003
Source: National Ambulatory Medical Care Survey, 2003 Emergency Department Summary,
Centers for Disease Control and Prevention, May 26, 2005
ED Visits to Florida Hospitals
Florida’s Population and Number of Hospital Emergency Departments
Average Number of Emergency Department Visits per Day to Florida’s Hospitals
Total Beds and ICU Beds in Florida’s Hospitals
Requirement of medical staff participation
Created a base of potential patients for new physicians
Specialists couldn’t practice without hospital privileges
Exempt because of medical staff tenure
Life style issues
Adverse impact on medical practice
Increased liability exposure
Specialties no longer need hospital to practice
Specialist shortagesIssues of On-Call Coverage
Source: “Specialist On-Call Coverage of Palm Beach County Emergency Departments,” MD Content Study commissioned by the Palm Beach Count Medical Society Services, December 13, 2004
Florida Access to Emergency Services (Ch. 395.1041(3)(d) F.S)
Board of Medicine
Source: “Specialists Shortage Shakes Emergency Rooms; More Hospitals Forced to Pay for Specialists Care,”
The Physician Executive, May-June 2005.
Source: Health Care Advisory Board, May 2005
NOTE: This was incorporated into another standard where it address other areas of the hospital too, not just the ED.
A situation in which the identified need for emergency services outstrips available resources in the ED. This situation occurs in hospital EDS when there are more patients than staffed ED treatment beds and/or wait times exceed a reasonable period. Crowding typically involves patients being monitored in non-treatment areas awaiting ED treatment beds or inpatient beds. Crowding may also involve an inability to appropriately triage patients and/or a large number of patients in the ED waiting area of any triage assessment category.
A situation when patient need, defined as timely evaluation and treatment based on triage assessment category, cannot be met for existing and/or additional patients due to fully committed ED resources.
Source: Arizona College of Emergency Physicians, May 15, 2002