Media campaign educates public on ED overcrowding

Everyone talks about how the public misuses EDs and cause overcrowding, but nobody does anything about it, right? They do in Memphis, TN, where a hospital system is working to educate the public about when and when not to use the local EDs, with good results after just a few months.

Baptist Memorial Health Care, a 17-hospital system with three in the Memphis area, recently launched an educational campaign to educate the public about when and when not to come to the ED, says Beverly Jordan, vice president and chief nursing officer at Baptist Memorial Health Care.

The campaign’s $75,000 effort includes billboards, radio spots, and print advertisements, she notes. The funds came from Baptist Memorial’s corporate communications budget, and Jordan says it appears the money was well spent.

Taking the pressure off

The campaign already is taking some pressure off local EDs, which have been suffering from overcrowding just as much and for the same reasons as most other EDs across the country, she says.

Jordan reports that from October 2001 through September 2002, Baptist Memphis’ ED treated 53,000 patients with 43 beds, Baptist DeSoto’s ED treated 32,843 patients with 26 beds, and Baptist Collierville’s ED treated 25,806 patients with 13 beds.

ED volume has decreased about 5% over the first four months of the media campaign, says Chuck McGlasson, RN, BSN, MS, director of emergency services at Baptist Memorial Hospital-Memphis.

"We know that the word is out because some of our patients seeking minor treatment mention the ads and say they don’t know if their injury is appropriate for the ED or not, but they thought they would come in and ask," he says. "We consider that a real step forward because they’re thinking that way."

Patients directed to other care

Jordan says Baptist Memorial decided to fund the campaign because overcrowding had become a serious problem in its EDs — maybe more so than in the typical hospital.

Statistics from the Centers for Disease Control and Prevention (CDC) indicate that there were 108 million ED visits in 2000, up 14% from 95 million visits in 1997, according to the CDC’s report National Hospital Ambulatory Medical Care Survey (available at www.cdc.gov/nchs/).

In Tennessee, however, those increases have been even more dramatic. According to information released by the Nashville-based Tennessee Hospital Association in late 2002, the number of ED visits at the state’s hospitals has increased 31% in three years.

Representatives from Baptist Memorial EDs met for more than a year with the system’s marketing and communications departments to develop the campaign.

"Most of the concerns involved people accessing emergency services when they could go somewhere else if they knew to do that," McGlasson says. "These patients don’t want to wait hours in the ED any more than we want to be overcrowded, so a large part of this is just educating them about other options."

Print, radio, and TV ads

The effort involves print, radio, and television public service announcements and other tactics that address proper use of EDs, urgent vs. emergent care issues, health care options, and information about flu and the national ED situation in general.

Baptist Memorial received some assistance in the campaign from the Tennessee Hospital Association, the Jackson-based Mississippi Hospital Association, and the Memphis and Shelby County (TN) Health Department.

Nonemergent patients make problem worse

The campaign features a billboard that says "Help Reduce E.R. Crowding. For flu symptoms, see your doctor." It also includes free public events, such as a flu shot day.

Though the campaign focuses largely on directing patients with nonurgent conditions to providers other than the ED, Chris Andershock, MD, medical director of the ED at Baptist Memorial Hospital-Memphis, acknowledges that those patients are not the main cause of the overcrowding crisis. However, when the ED is overcrowded for whatever reason, those nonurgent patients only make the situation worse, he points out.

For any ED manager interested in launching a similar campaign, McGlasson advises focusing first on statistics that illustrate who is coming in and what treatment they’re seeking.

"What is the target you want to decrease? You don’t want patients with chest pain to go somewhere else, but those with colds and orthopedic injuries can be sent to their primary care physicians," he says. "If you get overrun with patients every flu season, focus part of your campaign on that specifically."

About 20% of the patient volume in the Baptist Memorial Memphis ED is directed through its fast-track system, so staff take advantage of the opportunity to educate them at that point. The staff are careful not to give the impression that they’re shooing patients away, but rather to alert them to alternatives they might prefer.

"We tell them they’re welcome here and we’ll surely take care of them, but that there are other options," he says.

"We start by referring them to a minor medicine clinic to have their stitches taken out later, instead of coming back to the ED for that."

Sources

For more information on Baptist Memorial Health Care’s education campaign, contact:

  • Chris Andershock, MD, Medical Director of the ED, Baptist Memorial Hospital-Memphis, 6019 Walnut Grove Road, Memphis, TN 38120. Phone: (901) 226-5000.
  • Beverly Jordan, Vice President and Chief Nursing Officer, Baptist Memorial Health Care Corp., 350 N. Humphreys Blvd., Memphis, TN 38120. Phone: (800) 422-7847.
  • Chuck McGlasson, RN, BSN, MS, Director of Emergency Services, Baptist Memorial Hospital-Memphis, 6019 Walnut Grove Road, Memphis, TN 38120. Phone: (901) 226-5000.