Emergency departments (EDs) in the United States serve a dual role in public health: a portal of entry to the health system and a safety-net for the community at large. Public health officials often target the ED for public health (PH) interventions due to the perception that it is uniquely able to reach underserved populations. However, under time and resource constraints, emergency physicians and PH officials must make calculated decisions about which interventions in their local context could provide maximal impact.

In this paper, we propose a framework, based on the Consolidated Framework for Implementation Research model, through which to evaluate, select, and prioritize ED-based PH interventions. We recognize that the decisions regarding PH interventions are affected by considerations of cost, time, and available personnel. We describe a sample of ED-based PH interventions and demonstrate how to use the proposed framework to assess interventions.

We posit a series of questions and variables to consider: local disease prevalence, ability of the ED to perform the intervention, relative efficacy of the ED vs community partnerships as the primary intervention location, and expected outcomes. In utilizing this framework, clinicians should be empowered to improve the public health in their communities.