Ask the expert: When measuring the burden of ED call, which patients should the hospital collect data on?

To measure the burden of ED call on your medical staff, it is important to collect data on unassigned patients, but first you must define the term “unassigned ED patient.” It is a patient who, in the judgment of the attending emergency physician, requires on-site consultation, which may include admission, and does not have a private physician to arrange specialty care. The designation of unassigned status is independent of patient funding. For some specialties, such as general surgery, emergency patients are most all unassigned patients, unless specialists have a prior relationship with the patient.

When collecting data on unassigned patients, be sure to include all of the following:

• ED admission of unassigned patients
• ED non-admission of unassigned patients
• Trauma patients
• OB unassigned patients bypassing the ED
• Pediatric unassigned patients bypassing the ED
• Psychiatric unassigned patients bypassing the ED
• Transfer patients admitted to the specialist on call

This week’s question and answer are adapted from Emergency Department On-Call Strategies, Second Edition by Jonathan H. Burroughs, MD, MBA, FACPE, CMSL; Martin B. Buser, MPH, FACHE; Roger A. Heroux, MHA, PhD, FACHE; and Richard A. Sheff, MD, CMSL.