Freeing up the ER for real emergencies

Inappropriate use of emergency departments is a large problem for hospital staff trying to provide care for those who need it most.

In their study of emergency room use at St. Paul's Hospital in downtown Vancouver, Dorothy Pope and colleagues found that 24 patients visited the emergency department a total of 616 times during the course of one year. The authors report that in addition to physical ailments, heavy users of emergency rooms also often have social or psychological problems.

In an attempt to ease the problem of patients blocking emergency rooms with conditions that could be treated in the community setting, the authors devised a care plan for frequent users. Through the involvement of social workers, emergency and family physicians, psychiatric nurses and community care providers, the same patients made a total of only 175 visits in the year after the program was implemented.