One of television’s most urgent new dramas, HBO Max’s The Pitt, rips the curtain back on the relentless fight for access to acute care, depicting an overcrowded, understaffed and under-resourced emergency department at a fictional Pittsburgh hospital. But for today’s healthcare leaders, the crisis onscreen is all too real: Across the country, emergency departments are buckling under the weight of patient surges, staffing shortages and clinician burnout, resulting in dangerously prolonged wait times, boarding and, most critically, barriers to timely acute care.
“Rising costs, shrinking reimbursements and workforce shortages all converge into a single, critical issue: limited access to acute care for patients,” says Rachel Thompson, MD, CMO at Core Clinical Partners.
Revolutionizing Patient Flow and Transfers
To open the bottleneck and get patients the acute care they need, organizations are rethinking transfer coordination and patient flow. Innovative command center-style transfer hubs, like the Judy Reitz Capacity Command Center at Johns Hopkins, use predictive analytics and real-time tracking to optimize patient flow and anticipate surges, enabling hospitals to flex staffing and resources. Even mid-size hospitals are leveraging EHR tools to pinpoint bottlenecks and streamline transfers, ensuring that acute care beds are available.“This is care coordination in a superpowered way,” says Thompson. “It doesn’t erase the fact that some days there are no physical beds available, but it does give us line of sight to figure out why.”
Telemedicine: Care Without Walls
Widespread healthcare workforce shortages have made telemedicine a vital tool for maintaining care access despite limited on-site staff.
“At Core, we have leveraged telemedicine to extend our clinician workforce, allowing more clinical care without driving up costs,” Thompson says. “When deployed properly, telemedicine can also redistribute time-consuming tasks such as nursing intake, hospitalist admissions or even ED triage.” Additionally, telemedicine can bring specialists to the bedside where they may not have been available in the past, broadening the reach and access.
Thompson suggests that “the potential for telemedicine to shatter barriers to access is limited only by our imagination—and our willingness to turn bold ideas into reality.”
Policy, Infrastructure and Workforce: Building Capacity for Acute Needs
Improving access to care depends on having enough caregivers; innovative ways to grow this workforce are needed. Thompson asks, “How do we incentivize individuals to the field? Are there ways to offer loan forgiveness? How else can we pull people into medicine, whether it’s nursing or lab tech or clinician—wherever our shortages are?”
Offering more training and education can help grow the workforce, especially in areas like mental health that face ongoing shortages. Building up the workforce is essential for meeting patient needs. Thompson also suggests infrastructure changes, such as hospital-at-home programs, which let hospitals care for more patients without needing to build new facilities.
“There are some creative ways we can increase the number of places where we care for people without necessarily building new hospitals,” she says. She adds that creating dedicated behavioral health centers would help keep mental health patients out of the ED and ease the strain on acute care. Many patients end up in the ED because there aren’t better options for their needs.
By focusing on workforce growth, new care models and better mental health resources, hospitals can make meaningful progress in expanding access to acute care.
Whole-Person Care and Social Determinants
Access to acute care isn’t just about beds and staff—it’s also about addressing the root causes that lead patients to seek it in the first place. Factoring in social determinants like housing and access to medication can prevent unnecessary acute care utilization and ensure that resources are reserved for true emergencies. Integrating social determinants of health into patient care workflows can make a meaningful impact.
“When patients are dealing with financial strain, housing instability or other challenges, it significantly affects what we’re able to do for them,” Thompson says. She explains that many patients return to the hospital simply because they lack access to essential medications or a safe place to recover.
Culture and Collaboration: From Silos to Synergy
Ultimately, improving acute care access demands investment in people and culture. Multidisciplinary teams, equipped with the right tools and empowered to communicate, can unlock capacity and accelerate patient flow.
“You need to have multidisciplinary teams with skilled people equipped with the right education and resources to do their job well. When they’re coming together and communicating on a regular basis, that can open beds,” Thompson says. “In the hospital, one of the best models is to hold a brief morning multidisciplinary huddle to identify what can be done today to get appropriate patients discharged, coupled with an afternoon multidisciplinary meeting to address more complex matters regarding flow.”
She cites her organization’s partnership with one large urban hospital that, prior to its work with Core Clinical Partners, was turning away 500 patients every month due to a lack of beds. “Thanks to collaborative efforts across multidisciplinary teams, 93% of those patients are able to access the care they need.”
The Pitt may be fiction, but the struggle for acute care access is a reality demanding bold solutions, relentless innovation and unwavering focus on getting every patient the right care, right now.
“When even one patient can’t access acute care, the impact is profound,” says Thompson. “Across the country, patients are waiting right now—waiting for the level of care they desperately need.”
If you’d like to discuss strategies for improving acute care access or integrating clinician leadership into system-level solutions, feel free to reach out to Dr. Rachel Thompson, Chief Medical Officer at Core Clinical Partners, at rthompson@coreclinicalpartners.com.