Important historical efforts at emergency department categorization in the United States and implications for regionalization.
This article is drawn from a report created for the American College of Emergency Physicians (ACEP) Emergency Department (ED) Categorization Task Force and also reflects the proceedings of a breakout session, "Beyond ED Categorization-Matching Networks to Patient Needs," at the 2010 Academic Emergency Medicine consensus conference, "Beyond Regionalization: Integrated Networks of Emergency Care." The authors describe a brief history of the significant national and state efforts at categorization and suggest reasons why many of these efforts failed to persevere or gain wider implementation. The history of efforts to categorize hospital (and ED) emergency services demonstrates recognition of the potential benefits of categorization, but reflects repeated failures to implement full categorization systems or limited excursions into categorization through licensing of EDs or designation of receiving and referral facilities. An understanding of the history of hospital and ED categorization could better inform current efforts to develop categorization schemes and processes.
Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA. Abhi@med.unc.edu
Abhishek
A
Mehrotra
David P
DP
Sklar
Vivek S
VS
Tayal
Keith E
KE
Kocher
Daniel A
DA
Handel
R
R
Myles Riner
D002391:Catchment Area, Health; D004636:Emergency Service, Hospital / Q000145:classification* / Q000592:standards*; D006801:Humans; D007591:Joint Commission on Accreditation of Healthcare Organizations; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D012955:Societies, Medical; D014481:United States