When northern Michigan’s population spikes in the summertime, so do the demands on the local health care system. But just how many patient visits does Munson Medical Center (MMC) incur to its Emergency Department (ED) during peak tourism season? And how successful has Munson been in curbing emergency room visits and triaging patients to avoid a system overload? With the summer officially in the rearview, The Ticker crunches some season-spanning numbers from the Munson ED.

50,000+: Approximate number of patients that cycle through the MMC ED each year.

18,272: Total patient visits to the MMC ED between May 1 and August 31, 2024. According to Regional Manager Marketing & Communications Manager Brian Lawson, that number is right on par with what the hospital tracked during the summer of 2023.

41%: Share of total MMC ED visits so far this year that occurred during the months of June, July, and August.

188: Highest single-day volume of patients admitted to the ED this summer, which Lawson says occurred in mid-July.

400+: Peak inpatient census at MMC – both for this summer and in hospital history – according to MMC President Joe Hurshe. That apex occurred the week after the National Cherry Festival.

“That’s actually kind of rare, compared to previous years,” Hurshe says of the timing. “Usually, the week of the Cherry Fest tends to be our highest activity week: lots of volume, lots of patient presentations. The ED was atypically quiet this year during the actual Saturday-to-Saturday of the festival. But right after the festival ended that Sunday, we started to see a real significant uptick in all facets of our care. And then that uptick kind of carried on through the rest of the month; it was a very busy July.”

“It was no one thing,” Hurshe elaborates, when asked what drove the July bustle. “It was just a wide array of everything from sports injuries to seasonal allergies. There's also still a large concentration of patients that don't have a dedicated primary care relationship, and they still look to emergency services as a source of their primary care.”

COVID-19 continues to cast a shadow, too. In the late summer, Hurshe says, MMC saw “a little bit of an uptick in COVID patients that have required either inpatient hospitalization or presented at the ED for levels of care related to COVID.”

12,870: Calls to Munson’s Ask-A-Nurse Hotline across May, June, July, and August – a 20 percent increase from the same period last year. Munson launched that service during the peak of the pandemic, then partnered with Traverse City Tourism last summer to get the word out to out-of-town visitors. Ask-A-Nurse is designed to cut down on ED visits by giving patients – particularly those without easy or local primary care access – to get fast answers for health-related questions.

“That’s a really good support service for us,” Hurshe says of Ask-A-Nurse. “It’s free of charge, it’s available 24/7, and we’ve gotten great feedback on it from our patients.”

35.6%: The share of ED patients this summer who scored a 1 or 2 on the Emergency Severity Index (ESI), the system Munson uses to assess how urgently a patient needs to be seen. The ESI rates patients on a scale of 1-5. Scores of 1 or 2 indicate severe or even life-threatening conditions, while 4s or 5s indicate patients with less “severe/emergent” needs – those who “could receive the same care at primary care or urgent care offices,” per Lawson.

Speaking to The Ticker last summer, Dr. Joe Santangelo, Munson’s chief medical, quality, and safety officer, said one of the organization’s long-term goals was to “reduce the number of 4s and 5s in the ED by sending them to the right place at the right time. And then, as a result, the 1s, 2s, and 3s would be seeing more efficient wait times and better-quality care.” Santangelo specified that issues like chest pains or heart attack symptoms would always rate as 1s or 2s, while something like a rash would be more likely to earn a 4 or 5.

Statistically, Lawson says, ESI scores tend to follow a standard bell curve. This summer, only 4.2 percent of patients scored a 1, while only 1.2 percent were scored a 5. 31.4 percent were scored as 2s, 49.5 percent as 3s, and 13.5 percent as 4s.

7.5%: Percentage of MMC ED patients this summer who received treatment in the “Quick Care Zone.” Launched via a two-month pilot program in mid-June, the Quick Care Zone is a designated area within the ED where patients who score 4s or 5s on the ESI can be prioritized. During its pilot run, the Quick Care Zone consisted of five curtained spaces where patients could receive “vertical care,” or treatment in a recliner rather than a hospital bed.

“Our goal is to get those less emergent patients in and out within a couple of hours, versus having them be in line with all the other emergency patients,” Hurshe says.

460: Patient visits to the Quick Care Zone in July alone, per Tori Sykes, Munson’s director of nursing for emergency services and operations. Skyes said in a press release that those patients experienced an average arrival-to-departure time “16 minutes better than the national average and 23 minutes better than the average in Michigan,” and that hte program was also delivering “a positive impact on the overall wait for an emergency room bed, which has improved 34 percent from a year ago.”

152: The average wait time, in minutes, for patients treated through the Quick Care Zone this summer. The national emergency room average is 162 minutes, while Michigan’s statewide average is 169 minutes.

Those numbers could improve with future growth to the Quick Care Zone. According to Hurshe, Munson leadership was so pleased with the two-month pilot program that the Quick Care Zone has now been made a permanent part of the ED. “We do believe there will be expansion to that over time,” he says, noting that Munson will do an “internal review” of the program in September to decide how many more treatment bays are needed in the Quick Care Zone to meet clinical demands.