Future of Emergency Care

In June 2006, the Institute of Medicine (IOM) Committee on the Future of Emergency Care in the U.S. Health System released a series of reports on the state of emergency care. The reports, Emergency Medical Services at the Crossroads; Hospital-Based Emergency Care: At the Breaking Point; and Emergency Care for Children: Growing Pains, identified a number of disturbing problems including overcrowded emergency departments, a lack of coordination among emergency providers, variability in the quality of care provided to patients, workforce shortages, lack of disaster preparedness, a limited research base, and shortcomings in the systems' ability to care for pediatric patients. These problems, while apparent to those who work in the field, are largely hidden from public view, in part because popular fictional television programs frequently depict the emergency care system in fine shape. Despite the lifesaving feats performed every day by emergency departments and ambulance services, the nation's emergency medical system as a whole is overburdened, underfunded, and highly fragmented. The IOM received funding from 14 organizations to conduct a series of dissemination workshops associated with the release of the 2006 reports on the future of emergency care. Three one-day regional dissemination workshops were conducted in Salt Lake City, Utah (September 7, 2006), Chicago, Ilinois (October 27, 2006), and New Orleans, Louisiana (November 2, 2006). Each of the workshops featured focused discussions in two issue areas. The meeting in Salt Lake City focused on pediatric emergency care and care in rural areas; in Chicago it was workforce issues and hospital efficiency; and in New Orleans it was EMS issues and disaster preparedness. A fourth capstone workshop, held in Washington, D.C., provided an opportunity to engage congressional and other federal policy leaders in a discussion of emergency care issue. Future of Emergency Care summarizes the proceedings of the workshops. Each regional workshop began with an overview of the findings and recommendations from the three reports on the future of emergency care. Findings and recommendations from those three reports are also summarized in this report.