Chronic Disease Management in the Emergency Department

Course overview

While the demand for emergency department (ED) care remains high, EDs continue to decline in number nationwide. Those that remain are overcrowded and at capacity, often having patients wait hours or even days to be admitted. Although many seek care in the ED for an acute injury or illness, others seek treatment for acute exacerbations of poorly managed chronic illness, such as diabetes, or management of a chronic illness in the absence of an acute problem, such as for blood pressure control and cardiac or asthma medication refills. The ED has become the largest provider of unscheduled primary care visits, seriously stressing the healthcare safety net. Patients in the ED are staying longer for prolonged observation and complex diagnostic workups. There is an increasing number of critically ill patients being treated and cared for in the ED rather than the critical and intensive care unit. Additionally, chronic mental and psychiatric patients often seek treatment in the ED rather than with individual providers. This has resulted in overcrowding in the ED, putting strain on its personnel.