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BY PATRICK SCHULTZ & DAVID R. VINCENT In some states, the number of freestanding emergency departments is increasing rap- idly, as shifting care patterns necessitate diversifi cation away from acute care and as hospitals seek to increase greater access to care in their communities. As hospitals develop continuum of care strategies, FSEDs represent a growing alternative to traditional hospital-based EDs, providing a comprehensive patient care ED solution in more convenient, easy-to-access locations and consumer-oriented environments. There are three basic types of emergen- cy departments/freestanding emergency departments: 1. Hospital-based emergency depart- ment, the traditional model 2. Hospital-af liated freestanding ED, the ambulatory extension model for estab- lished hospitals 3. Non-hospital af liated FSED, or inde- pendent freestanding emergency centers. These facilities must have patient transfer and admitting arrangements in place with an existing hospital. As annual visits to the traditional hospital-based EDs continue to increase with usually longer waiting times as a result, patients are left seeking other more accessible and convenient ED options. FSEDs provide patients with an alternative to greater access to care for non-life threat- ening conditions with generally less wait- ing times. These faster turnaround times can be a key driver to increased patient satisfaction for FSEDs and their af liated hospitals or health systems. Urgent care centers versus FSEDs Hospitals recognize urgent care centers as a convenient, quick solution to a low-acuity health issue. Compared to FSEDs, urgent Trends in freestanding emergency departments BRIDGING THE GAP care centers are usually lower in cost, refl ecting the lower staf ng levels, and lower levels of technology and equipment required to operate UCCs. In this respect, urgent care centers can operate more similarly to a primary care practice than to a traditional hospital ED or FSED. Urgent care centers are less likely to transfer patients for nearby hospital admission, not be open 24 hours and not be accredited the same as ED/FSEDs. Because FSEDs operate 24/7, require a license as a department of the hospital or, if independent, have transfer and admit- ting arrangements with a nearby hospital for high-acuity patients; FSEDs are increasingly preferred by patients over urgent care centers. 40 years The FSED concept emerged in the early 1970s and was intended for rural or underserved areas. 92% Number of freestanding emergency departments (FSEDs) located in urban areas. ISSUE FOCUS Support Facilities The hospitality-inspired design of the emergency lobby and check-in spaces in Mount Carmel Health System's freestanding emergency department in Grove City, Ohio makes use of vegetation, warm materials and access to natural light. This creates a more relaxing environment for patients, family and staff. 32 Medical Construction & Design | M A RCH /A PR IL 2015 | MCDM AG.COM