To the List:
I am seeking information and opinions about the following:
For the past several years the department of Pediatrics at The
University of Texas - Houston has operated an after hours clinic from 6
PM to 11 PM on weeknights and from 3 PM to 11 PM on weekends. The clinic
has been located in a separate part of the hospital and has had separate
staffing. The current volume is 200 to 300 patients per month. About 2/3
of these patients have minor acute illnesses and the other 1/3 present
for 2 day well baby follow-ups etc.
With the opening of our new emergency department, which has a larger
pediatric area, the hospital has made the decision to move after hours
clinic into the emergency department, which currently sees about 600
children per month.
The current plan calls for the staff from the after hours clinic to be
added to the ED staff during the hours that the after hours clinic is
operating in hopes that these individuals can seen both the after hours
clinic patients and the lion's share of children presenting to the ED. A
longer range plan is to have PEM trained physicians who can oversee both
When the after hours clinic is in operation, it will literally be across
a common hallway from the Pediatric ED.
The challenges are:
1. Maintaining some identity for the after hours clinic so that it does
not lose its appeal for the managed care companies.
2. Establishing appropriate billing for the after hours clinic separate
from the the emergency department bill with a cost structure that
appeals to insurers.
Has anyone done something similar?
If so how did you solve these and other associated problems?
Any suggestions or ideas would be most welcome.
PS feel free to reply directly to me so as not to clutter the list.
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