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Patient acuity, volume and access FSEDs are usually located to serve as an anchor to an ambulatory facility within a high-growth market opportunity. Successful development of FSEDs will depend on analyzing the targeted primary or secondary service area patient popula- tion, availability and future market volume forecast to determine if the new FSED will bridge future growth in outpatient ambulatory care, inpatient services, beds or both. Patient acuity mix and distribution will likely dif er from a traditional hospital- based ED due to the lower-acuity patients that may come through the FSED. A tra- ditional ED generally serves patients with higher severity conditions due to being a part of the hospital and availability of on-call specialists. FSEDs can realize new volumes from patients who would not go to an ED otherwise because of geographic accessibility and convenience. As a result, FSEDs may experience volume not previ- ously anticipated. Building the fi rst FSED can be advantageous, but as FSEDs may breed more competitors over time, market capture projections should include a sen- sitivity analysis. Reduced wait times can enhance higher levels of patient satisfaction, and help promote higher volume and market share. FSEDs should be branded dif erent- ly, with an emphasis on customer service and, similar to the retail industry, consum- erism. A customer preference-of-choice approach will result in convenience and accessibility for both patients and families, which are key characteristics of successful FSEDs. Patient care delivery model Some hospital-based EDs are very ef- fi cient and streamlined with their patient intake process; the freestanding emer- gency department can potentially of er a more ef cient operating environment than a traditional hospital-based ED. FSEDs with more streamlined management structure, and operating 24/7, require a dif erent layout — less waiting room times, minimize the size of waiting areas and bypassing typical triage and registration and go straight to the "direct bedding" of patients. Built to traditional hospital-based ED standards, the FSED is derived from the successful ED workfl ow and patient care model in a cost-ef ective and high-quality Above: An illuminated night view of Christiana Care Health System's freestanding emergency department in Middletown, Delaware displays a cantilevered-glass emergency entrance canopy at the patient arrival and drop-off area. Left: Patient treatment area in Mount Carmel Health System's freestanding emergency department. 38 Average number of patients per day in a freestanding ED is 38, compared to 125 in a hospital's ER. 60-90 minutes Average length of a visit in a freestanding emergency department per patient. Mt Carmel: JE Evans; Christiana: HKS/Blake Marvin MCDM AG.COM | M A RCH /A PR IL 2015 | Medical Construction & Design 33