Physician viewpoint: Hospitals must stop holding ER beds for elective admissions

Many hospitals prioritize elective admissions over emergency room admissions due to financial incentives, which is a growing issue the healthcare industry must address, two ER physicians wrote in an op-ed for The Washington Post.

The op-ed's authors are:

  • Richard Klasco, MD, assistant professor of emergency medicine at the University of Colorado School of Medicine in Aurora
  • Richard Wolfe, MD, department of emergency medicine chair for the Harvard Medical Faculty Physicians group at Boston-based Beth Israel Deaconess Medical Center

In the op-ed, Drs. Klasco and Wolfe said hospitals often give ER beds to elective admissions first, instead of to ER patients, since the former typically arrive on time, are well-insured and undergo invasive procedures that create a significant revenue stream for the hospital.

When hospitals encounter a weekday peak in elective admissions, they often place admitted patients in the ER until a bed is freed up for them. This process, known as "boarding," is both inconvenient and unsafe for patients, the physicians argued.

"The problem of boarding can be solved by increasing inpatient hospital bed capacity, but the cost of increasing capacity can be daunting," Drs. Klasco and Wolfe wrote. "An alternative is to increase efficiency by a process known as 'smoothing.' Smoothing reorients schedules to distribute surgical cases uniformly across the workweek, mitigating the bottleneck to emergency admissions."

To read the full op-ed, click here.

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