Quality Field Notes: Reducing Inappropriate Emergency Department Use


Hospital emergency departments (EDs) are indispensable to the acute health care system. Yet, many ED visits are not emergencies or could be prevented with effective and timely outpatient care. EDs offer convenient access to care after-hours and for people without a regular primary care physician, and until recently, most insurance plans did not discourage their use.

Patient demand for EDs is increasing, even as the number of hospitals with EDs is decreasing, leaving patients concentrated in more crowded EDs. Looking ahead, the aging population and growing burden of chronic disease will continue to put a strain on both primary care providers and EDs.

Key Lessons

  • Simple, gradual and targeted efforts to improve collaboration and communication with providers and patients can make all the difference in reducing ED use.

  • Data transparency on the use of health services can help identify avoidable ED use and the reasons behind it.

  • Initiatives to engage stakeholders to take action should involve working with them, not just talking to them.

Resources on Reducing Avoidable ED Use

The emergency room waiting area.

Resource Guide

This resource guide provides links and additional information for providers and organziations interested in learning more about reducing avoidable ED use.

Check out the resources
Doctors go over a patient's charts in the emergency room.

Case Studies From Aligning Forces

These three case studies from Albuquerque, Detroit, and Wisconsin highlight how three Aligning Forces communities tackled inappropriate ED use.

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An Interview With Jenifer Hughes

We sat down with Jenifer Hughes, executive vice president of Administrative Network, Inc., to find out how Detroit is implementing simple, low-tech interventions across a group of practices to help patients understand their options when they encounter a medical issue after-hours.

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Reducing Avoidable ED Visits

Find out how low-tech, common sense solutions achieved significant reduction in unnecessary ED visits in Detroit.

Read the guide