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ER or Clinic?

Avera Holy Family offers education to patients to save money, waiting, worry

March 8, 2017
Amy H. Peterson - Staff Writer ( , Estherville News

Dr. Randy Asman and Dr. Anthony Cook recently developed a plan to try something different with Avera Holy Family's emergency room and clinic.

"This isn't anything original with us," Asman said. "It is something happening in other communities, too."

A trip to the ER for injuries, headaches, or infections can quickly top $1,500 on average, according to a study by the National Institutes of Health.

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Avera is now offering screening for patients who come to the ER, who might be more appropriately treated at the Avera Medical Group Clinic.

"We do our best to provide great care. In the ER, it's not first come, first served. Those with the greatest need come first." Avera Holy Family CEO Dale Hustedt said.

Screening patients who could appropriately be treated at the clinic saves not only money, but possibly hours spent waiting in the ER for patients and carers.

"If I'm treating someone with a heart attack, others in the ER might wait two or three hours. I've talked to some who are upset about this, but I hope they're happy they were not the critical patient I was just treating," Dr. Asman said.

Hustedt said mid-level professionals at the clinic were vital to the new system working. "Chelsea Richardson [Physician's Assistant] and Sarah Walker-Loring [Family Medicine Nurse Practitioner] have been vital to making this work."

Mid-level professionals are able to see and treat many patient conditions independently, due to their education and training, but always have a medical doctor as backup when needed.

Avera Holy Family recorded 4,600 emergency room visits in 2016. "This was up from 2,500 a few years ago," Hustedt said.

The screening from the ER is connected to the call system for the clinic. "We have adjusted for space for patients to come in, and for scheduling," Hustedt said.

For example, a patient who comes into the ER at night with a minor burn or cut, could be screened, then referred to the clinic at 8 a.m. the next morning.

"The strength of this model is cost savings," Hustedt said.

Emergency room nurse manager Linda Adams said, "Screening is a way we can reassure the patient that they or their loved one is okay and will get the proper care in our clinic."

About the new process, which was launched March 1, Adams said, "The flow is going well. The staff is adjusting to that piece of it."

Dr. Asman said, "The ER will always be here for crises"

Hustedt said, "As healthcare policy changes, we can help reduce costs by educating patients better."

To see a full list of examples of when to visit the clinic versus when to come in to the ER, see the article on our website at



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