Overwhelmed by patient demand, Urgency Room abandons walk-in models and shifts to reservations – Twin Cities

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When the Urgency Room first opened the doors of its inaugural Woodbury clinic in 2010, the emergency room physicians running the flagship operation promised an intensive new take on walk-in care, this one featuring X-rays, ultrasounds, sedation and other aspects of an emergency room set-up, minus the helicopters and ambulances.

Then came the pandemic and a growing wave of burnout in the healthcare industry. On Thursday, the Urgency Room — which now spans three east metro locations in Woodbury, Eagan and Vadnais Heights — announced that it was abandoning a key component of its initial care model.

Rather than see patients exclusively on a walk-in basis, the Urgency Room has shifted to scheduled care, with reservations required and accepted up to 12 hours in advance. Exceptions will still be made for highly acute conditions like stroke symptoms and bone fractures, as well as referrals from other emergency rooms and nurse lines.

“Before, it was completely walk-in,” said Dr. Craig Matticks, medical director for the Urgency Room, in an interview Thursday. “We didn’t do any scheduled visits. You just showed up. We would see everybody that got in the door. That just became unsustainable.”

‘Difficulty maintaining staffing’

Matticks said the shift from walk-in to scheduled care was prompted by growing patient volumes that have at times forced Urgency Room locations to close their doors.

“People show up between our opening and closing hours and find they can’t be seen because we were temporarily closed, because we were overrun,” he said.

He added: “Urgent cares are having difficulty maintaining their staffing, maintaining their hours. We found that we were really in the past six months burning out our staff. We can’t replace them. There’s just so few bodies available.”

Last year, the three Urgency Room sites saw 103,000 patients in person between them, and their online care handled about 8,000 to 10,000 patients.

In fact, “2022 set another volume record for our organization, just like 2021 did,” Matticks said. Volumes were up by about 6,000 patients, including 11,000 more patients seeking in-person care as opposed to tele-medicine. “Not only did we see more patients, but more of them came to seek care in our bricks and mortar building than ever before,” he said.

More demand

As other providers have closed or scaled back services in light of staffing shortages, that’s placed more demand on the Urgency Room, which like other urgent care providers has seen long lines of patients seeking testing for COVID, influenza and RSV, a respiratory virus that was widespread this fall. While COVID numbers appear to be climbing, RSV peaked before the holiday.

“We were seeing so many low-to-moderate acuity patients we were having trouble seeing higher acuity patients,” Matticks said.

The shift toward scheduled visits began on a two-week trial basis in Woodbury in mid-December, and “patients adapted very quickly,” Matticks said.

A key benefit for the Urgency Room has been staggering their rate of arrival. Walk-ins tended to cluster around opening hours in the morning and then in the late evening, putting scheduling pressure on staff and making it unlikely everyone would be seen before closing.

“So far, it seems like it’s working for us,” Matticks said. “It is a trial still.”

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