Healthy ED–Urgent Care Referral Relationships Can Save Lives

The story of a young woman who died after leaving the emergency room to get faster care at an urgent care center in Wisconsin recently continues to make headlines. The 25-year-old reported to the ED with chest pains and shortness of breath. She was actually seen in fairly short order; x-rays showed an enlarged heart and she was sent back to the waiting room—where she waited for more than 2 hours. Fed up and nervous about her condition, she decided she couldn’t wait any longer and managed to drive herself to a nearby urgent care location. She collapsed in the parking lot and died in an ambulance on the way back to the hospital to where she had originally presented. Her cause of death was determined to be hypertensive cardiovascular disease. It’s impossible to know whether her outcome would have been different if she had been seen sooner. However, had the ED not been so backed up it’s unlikely she would have had to wait so long. Maybe she would have survived. There’s no suggestion to be made that she should have gone to urgent care from the outset, given the acuity of her complaints, but this tragic story does underscore the important role urgent care plays (or at least should play) in helping reduce ED traffic—and along with it, excessive wait times for people with truly emergent and life-threatening complaints. Make contact with ED supervisors in your area. Ensure they understand the breadth of your capabilities to take nonemergent patients off their hands when there are too many patients in the waiting room—freeing their clinicians to focus on the patients who truly need to be there.