Health progress (Saint Louis, Mo.)
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Many factors threaten the hospital emergency department. Socioeconomic and healthcare trends are forcing facilities to eliminate some services. Society's failure to deal with these issues portend disaster for high-quality care and for timely access to emergency care. ⋯ The emergency department has an impact on the facility's bottom line. The emergency department can positively affect this by ensuring accurate billing, analyzing fee schedules, and requesting payment at the time service is provided. Other survival issues include developing strategies to retain staff, develop management, negotiate managed care, and reassess the department's design.