Summaries of Independent Scientist (K) Awards

Asplin, Brent

Institution: HealthPartners Research Foundation, Minneapolis
Grant Title: Emergency Department Crowding: Causes and Consequences
Grant Number: K08 HS13007
Duration: 5 years (2002-2007)
Total Award: $616,950

Project Description: The goal of this project includes three types of factors that contribute to Emergency Room crowding: input, throughput, and output factors. Project Change will determine if an Advanced Access (AA) appointment system is associated with reduced Emergency Department (ED) utilization rates. The ED Crowding Project will develop feasible and reproducible measures of ED crowding. The ED Access Project was a national survey of ambulatory clinics that estimated the availability and timing of outpatient appointments for medical and surgical conditions requiring urgent ED followup care according to insurance status.

Career Goals: Dr. Asplin is the Department Head of Emergency Medicine and physician at Regions Hospital in St. Paul, Minnesota, a research clinician at HealthPartners Research Foundation, and an Assistant Professor of Emergency Medicine at the University of Minnesota. His primary career goal is to conduct quality health services research that will promote evidence-based reforms of the U.S. health care system. He also continues to practice emergency medicine in an urban safety net hospital. A secondary career goal is to achieve academic promotion in emergency medicine by publishing peer reviewed articles; conducting research; and participating in organized emergency medicine activities through research presentations and advocacy activities.

Progress to Date: Dr. Asplin was promoted to Department Head of Emergency Medicine in 2003 and has used this role to translate research ideas into practice. His work in 2004 primarily focused on translating research findings into practice through operational changes to improve patient flow and reduce ED crowding at Regions Hospital. He launched an operations improvement agenda entitled the BEST ED project (Building Efficiency, Satisfaction, and Teamwork). He gives lectures on ED crowding throughout the U.S. and Canada. He continues to serve on the Institute of Medicine's Committee on the Future of Emergency Care in the U.S. Health System, which will issue a report in late 2006. Two manuscripts based on research findings are under review and five have been published.

Future Plans: In 2005, he will explore how the ED operations database can be used to enhance the ability to predict bottlenecks in patient flow and to guide ED staffing decisions for periods of high patient census. Dr. Asplin is currently exploring the possibility of applying for Health Information Technology (Health IT) funding to support further development and dissemination of his operations database and decision support tool.

Highlights and Specific Accomplishments:

• Promoted to Department Head of Emergency Medicine.
• Completed data collection for all projects.
• Presented research at the Society for Academic Emergency Medicine Annual Meeting, and the AcademyHealth Annual Meeting.
• Served as Primary Investigator on AHRQ Integrated Delivery System Research Network (IDSRN) Task Order (Developing Data to Monitor and Reduce Emergency Department [ED] Overcrowding) which resulted in a diverse national panel of experts proposed measurement sets to monitor ED crowding.
• Served on expert panel on ED crowding for the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO).
• Appointed to the National Advisory Committee for Urgent Matters, a national program to study and reduce ED crowding by the Robert Wood Johnson Foundation (RWJ).
• Presented at national meetings including, the American College of Emergency Physicians, Association of American Medical Colleges, National Institute of Health Policy, and the Minnesota Medical Association.
• Appointed to the Institute of Medicine's Committee on the Future of Emergency Care in the United States.
• Named to America's Health Insurance Plans 2005-2006 Executive Leadership Program for Medical Directors (ELP-MD).

K-Generated Publications:

• Asplin BR, Magid DJ, Rhodes KV, et al. A Conceptual Model of Emergency Department Crowding. Annals of Emergency Medicine 2004;42:173-80.
• Asplin BR. Show me the Money! Managing Access, Outcomes, and Cost in High-Risk Populations. Annals of Emergency Medicine 2004;43(2):174-7.
• Kennedy J, Rhodes K, Walls CA, Asplin BR. Access to Emergency Care: Restricted by Long Waiting Times and Cost and Coverage Concerns. Annals of Emergency Medicine 2004;43(5):567-73.
• Solberg LI, Maciosek MV, Asplin BR, et al. Does Improved Access to Care Affect Utilization and Costs for Patients with Chronic Conditions? American Journal of Managed Care 2004;10(10):717-22.
• Magid DJ, Asplin BR, Wears RL. The Quality Gap: Searching for the Consequences of Emergency Department Crowding. Annals of Emergency Medicine 2004;44(6):586-8.

AHRQ Research Portfolios: Socio-Economics of Health Care; Training.
AHRQ Goals: Efficiency

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