June 2016 Bulletin

Urgent Care or Emergency Department: Ironing Out the Confusion

Tony Woodward BulletinOver the last several years, the growth of Urgent Care clinics has helped patients get quick medical attention. It has also caused some confusion about when a patient should go to an Urgent Care clinic and when they should go to the Emergency Department (ED). While Seattle Children’s is prepared to care for any patient, we can save families time and money by helping them understand where to best seek treatment.

Dr. Tony Woodward, chief, Division of Emergency Medicine, addresses some ways we can help sort out the confusion.

What is the main purpose of the Urgent Care clinics?

We created the Urgent Care clinics to help augment care available through our primary care providers’ offices and to add a less acute or expensive alternative to after-hours ED care.

Urgent Care is a good option if the child has a minor or non–life-threatening medical issue outside of standard primary care office hours. Seattle Children’s operates four Urgent Care clinics which are open weekday evenings from 5 to 10:30 p.m. and weekends and holidays from 11 a.m. to 8 p.m. Families and providers can even look online to see the estimated wait time at each clinic.

What level of medical complexity is appropriate to send to Urgent Care?

We’ve had several patients referred to Urgent Care with complex medical histories or concerns. If a patient’s situation can’t be assessed within a rapid new patient evaluation time frame, then Urgent Care is likely not the optimal site for evaluation and treatment. Our goal is to make care in the Urgent Care clinic and ED as efficient and focused on need as possible for the patients and families who require these services.

If the patient has a concern that they could be seen for in a primary care office, then they can likely be appropriately cared for in Urgent Care. However, if the underlying medical issues are complex, need consultant input, or significant labs/radiological assessment are indicated, these are often best provided in Seattle Children's ED.

Bottom line – we want to make the Urgent Care and ED processes as robust and efficient as possible so we can provide what the patient needs when they need it.

If a primary care provider isn’t sure where to send their patient, they can call the communication center at 206-987-8899 and we will help direct them to the best care location.

Is there a difference in cost or insurance coverage?

Yes, Urgent Care and the ED have different copays and different charges. It’s more expensive to be seen in an ED. However, it’s likely not as expensive as going to Urgent Care, then needing to be transferred to the ED by ambulance and incurring a charge for ED services.

Is sending a patient to a Seattle Children’s Hospital Urgent Care clinic the same as sending them to the hospital?

No – unfortunately, that tends to be another source of confusion. Families often think that when they go to a Seattle Children’s Urgent Care clinic, they’re going to Seattle Children’s Hospital. We own and operate four Seattle Children’s Urgent Care clinics, but they are limited in scope and don’t have immediate or on-site access to all Seattle Children’s services. Urgent Care providers are pediatric physicians and advanced-practice providers skilled in assessing and treating general medical issues. Urgent Care clinics do not have pediatric subspecialists on site.

Several primary care clinics have Urgent Care facilities within their system. Why should providers send their patients to Seattle Children’s Urgent Care?

At Seattle Children’s, all of our providers are trained in pediatrics and focus solely on children’s medicine. Because we’re all about kids, we don’t have to adapt general guidelines or adult-sized equipment or therapies to fit kids.

We also recognize the value and importance of communication and seamless transition between the medical home and acute points of care. We’ve designed a system where, for every single patient, we’re able to communicate with the patient’s regular provider prior to the visit through our communication center. If requested, we can also follow up with the patient’s provider electronically and/or via a direct call after the visit to ensure continuity in treatment.

How can we help families know whether to choose Urgent Care or the ED?

This is an area where primary care providers can really help. We have a great video and an online checklist providers can use or direct families to.

A simple rule of thumb is that Urgent Care clinics are appropriate for minor injuries or illnesses. If the child’s illness or injury is something severe or potentially life-threatening, they need to go to the ED.

Grand Rounds for July 2016 (CME Credit Available)

Upcoming Grand Rounds

  • TBA

Watch Past Grand Rounds Online (CME Credit Available)

  • Down Syndrome: Developmental, Medical and Neuroanatomic Determinants of Behavior
  • Dystonia in Childhood: Recent Advances and Ongoing Challenges
  • Susceptibility to HIV-1: Insights at the Convergence of Genetics and Epidemiology
  • Global WACh Presents: New Horizons in Global Pediatrics and How You Can Get Involved
  • Physical Activity and Outdoor Play in Early Childhood: Benefits for Health and Learning

For Provider Grand Rounds information, visit our website.

New Medical Staff and Allied Health Professionals for June 2016

Medical Staff

  • Catherine Albert, MD, Seattle Children's, Hematology-Oncology
  • Beth Harvey, MD, South Sound Pediatric Associates, Pediatrics
  • Molly Linhardt, MD, Bainbridge Pediatrics, PLLC, Pediatrics
  • Rashi Varma, MD, Yakima Valley Memorial Hospital, Hospital Medicine
  • Shilpa Vyas, MD, University of Washington, Hematology-Oncology
  • Daniel Zeitler, MD, Virginia Mason Medical Center, Otolaryngology

Allied Health Professionals

  • Julie Dodarell, ARNP, Seattle Children's, Neonatology
  • Jamie Koumoundouros, PA-C, Seattle Children's, Neonatology