How to Determine an ExpressCare or Emergency Department Visit

The baby spikes a fever at midnight.

You twist your knee mogul skiing.

Your daredevil wee-one takes a header from a bunkbed during a Friday night sleepover.

What is it about illnesses and injuries? They always seem to happen when we are least prepared and often when the doctor’s office is closed.

When health concerns arise, you may suddenly be faced with the question of where to go: The Emergency Department (ED) or a same-day walk-in clinic, like ExpressCare?

The key to making the right choice for care is understanding the difference between the severity of health issues that are treated by a same-day clinic versus in the ED. Click and save the graphic below to determine where you should seek care for different ailments and issues.

The primary reason for choosing the ED v. ExpressCare has a lot to do with how they are equipped, staffed and operating hours.

Open 24/7, the ED is staffed and equipped to treat life- or limb-threatening health conditions in people of all ages. When you require immediate medical attention for a potentially serious condition, the emergency department is the best option. 

ExpressCare is open daily from 8 a.m. to 6 p.m. and does not schedule appointments. ExpressCare can see patients for minor medical conditions that you would most likely see your primary care provider for as well. You can walk in and be seen by a member of the provider team. ExpressCare is staffed with physician assistants, nurse practitioners, and clinical staff who assess, determine if your health concern is appropriate to be managed in the clinic, and offers comprehensive and timely care. Volumes do fluctuate but wait times at ExpressCare can be shorter than the ED.

It is important to remember, that the staff working in ExpressCare understand the value of their patient’s time but also want to provide high quality, patient-centered care. This is reflected in their average visit time of 90 minutes from registration to discharge in ExpressCare. This time is dependent upon many factors like patient volumes, staffing, procedures, testing, and complexity of health concerns.

The same is true for the ED. Emergency care is initiated through a process called triage, which allows patients with potentially life-threatening conditions to be evaluated sooner by the next available physician. How long an ED visit takes also depends on many factors, most importantly, the severity of the individual’s medical concern.

During triage, things like patient history, patient vital signs, and the current medical concern are all taken into consideration. In cases of severely ill or injured patients, several tests, multiple nurses and doctors may require to assess and stabilize the patient. This demand on resources means that care time speeds up for some patients and slows down for others. For example, a complete evaluation for chest pain can take a minimum of 4 hours from start to finish. During that time, the patient will be monitored, reassessed, and undergo several tests to determine the cause of the chest pain. This time-consuming evaluation enables us to see if anything immediately life threatening is happening and take corrective action. It requires the same amount of time and resources to determine if nothing life threatening is occurring. In those cases, patients are referred to follow-up care to find the cause of your discomfort.

Regardless of where you go, it’s important to remember that nationwide there is an increased number of patients presenting to the ED. While wait times are rising, they should never deter anyone from visiting the ED if they believe they have a true medical emergency.

Jill Maynard, MSN, RN, CEN, SANE Director of Emergency Nursing and Bentley Munsell BSN, RN, CEN Clinical Nurse Manager of ExpressCare at Southwestern Vermont Medical Center.