Oct 02

An Urgent Care Physician’s Perspective: What does surge mean for Urgent Care?

When physicians sketch their vision of running an urgent care clinic, they may think that having a crowded waiting room would be a “good problem to have.” But when that reality hits – and the crowded waiting room gets even more crowded, it is imperative to have a surge plan in place, so that patients, physicians and staff know how to recognize a surge situation, and know what to do to avoid negatively impacting patient care or clinicians themselves. Surge goes beyond simple supply-and-demand; it is a serious and complex phenomenon. While it is most often associated with Emergency Departments, surge can happen in urgent care environments as well.

There are two key aspects of surge:

  • Medical surge capacity refers to the ability to evaluate and care for a markedly increased volume of patients—one that challenges or exceeds normal operating capacity.
  • Medical surge capability refers to the ability to manage patients requiring unusual or very specialized medical evaluation and care. Surge requirements span the range of specialized medical services (expertise, information, procedures, equipment, or personnel) that are not normally available at the location where they are needed (e.g., pediatric care provided at non-pediatric facilities). Surge capability also includes patient problems that require special intervention to protect medical providers and other patients. (Source: Medical Surge Capacity & Capability Handbook, US Dept of Health and Human Services)

The very nature of non-scheduled care makes it vulnerable to the ebbs and flows of consumers’ schedules as well as health-related causes like a flu outbreak or a virus that rips through an entire community.

“If you don’t have a clear Surge Plan and develop that plan, and practice that plan … no matter how much you’ve thought about Surge, if you haven’t planned for it and practiced end-toend, your staff won’t know what to do when it’s necessary.”

During a surge, patients must be prioritized very quickly in order to maximize resources. One surge workflow approach is to have a provider work alongside Registration and triage patients there.

5 Tips to Manage Surge

Managing Surge in an Advanced Urgent Care is a balancing act. Getting it right requires data, insights and creativity.

  1. Create a clinic-specific Surge definition. Identify triggers like door-to-doc time; waiting room patient volume; and patient-provider ratios that would indicate a Surge situation.
  2. Anticipate and plan for patient flow by looking at trend data based on previous performance tracking.
  3. Have a resource-expansion plan in place. Line up additional staff that can be called in when patient surge is likely.
  4. Clearly define the parameters of service. Determine in advance what issues fall outside your service capabilities. Be sure that registration staff are aware of how to advise patients of care alternatives.
  5. Provide “next day appointments” for non-urgent cases.

You can go up front and quickly assess a patient. Usually within 10 seconds of talking to someone you know what you need to do. Providers can expedite care by putting orders in (such as Xrays and labs), or even start a procedure.

Edaris Health, a leader in developing and deploying healthcare technology in emergency and advanced urgent care environments for more than 15 years, provides urgiChart, the only cloud-based EMR solution that meets the unique workflow and specific documentation needs of fast-paced nonscheduled environments.

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