Journal of Regional Medical Campuses

Emergency Department Provider Staffing among Critical Access Hospitals in Minnesota

Coleman Strosahl

University of Minnesota Medical School

Samantha Friedrichsen

Blue Cross and Blue Shield of Minnesota

Emily Onello

University of MN Medical School Duluth Campus

DOI: https://doi.org/10.24926/jrmc.v7i2.5260

Keywords: Rural, Emergency Room, Emergency Department, Medical Staff, Family Medicine Physicians, Emergency Medicine Physicians, Nurse Practitioners, Physician Assistants, Staffing Decisions

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Abstract

Background: Access to healthcare remains a challenge in many rural regions. Rural critical access hospitals (CAHs) remain essential access points. Providing 24-hour access, CAH emergency departments (EDs) rely on medical staff who can treat a wide range of problems. Family physicians/general practitioners have traditionally staffed rural EDs. However, this staffing model may be changing. This study aims to characterize the current medical staffing profiles of Minnesota’s CAH EDs.

Methods: From January to February 2021, the executive leaders of all of Minnesota’s 77 CAHs were invited to complete a voluntary online survey about ED staffing patterns at their facility.

Results: 37/77 of MN’s CAHs responded to the survey (48% response rate). Just over half (51.4%) of the respondents reported ED physician staffing practices that included multiple physician specialties (family medicine, internal medicine, emergency medicine) while 32.4% reported staffing exclusively with family medicine physicians. A majority, 27/37 (73%), reported including non-physicians on their ED medical staff, especially at CAHs that were part of a larger healthcare system.

Discussion: CAHs often operate with limited workforce and resource options. This study demonstrates that MN’s CAHs exhibit a variety of ED staffing patterns with staffing decisions driven by multiple factors. Family medicine physicians contribute to CAH ED coverage. Future studies may expand our understanding of how ED staffing models impact community health, disease outcomes, and CAH financial viability.

Conclusion: ED staffing patterns across Minnesota’s CAHs vary significantly with variable use of physicians and non-physician providers. Family physicians remain an important specialty for CAH ED coverage

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Author Biographies

Coleman Strosahl, University of Minnesota Medical School

Medical Student (MS4), University of Minnesota Medical School 

Samantha Friedrichsen, Blue Cross and Blue Shield of Minnesota

MPH

Blue Cross and Blue Shield of Minnesota

Emily Onello, University of MN Medical School Duluth Campus

Emily Onello MD, Associate Professor in the Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School Duluth Campus