Few Emergency Departments Meet Recommended Wait Times For Patients
Only 30 percent of emergency departments got the majority of their patients seen by a physician within recommended time frames, and only 13.8 percent of emergency departments achieved the triage target for the majority of patients who needed...
Washington, DC— Only 30 percent of emergency departments got the majority of their patients seen by a physician within recommended time frames, and only 13.8 percent of emergency departments achieved the triage target for the majority of patients who needed to see a doctor within one hour. Researchers report their findings today online in the Annals of Emergency Medicine (“United States Emergency Department Performance on Wait Time and Length of Visit”).
“We found that hospital emergency departments perform fairly poorly in seeing acutely ill patients within the time recommended by the triage nurse,” said lead study author Leora Horwitz, MD, MHS, of Yale University and Yale-New Haven Hospital in New Haven, Conn. “In addition, only 24.5 percent of emergency departments got patients needing admission admitted within four hours. That kind of delay at the back end increases the delay at the front end, when patients are waiting to be seen by the emergency physician. It creates a really dangerous situation, especially for the sickest patients.”
Researchers examined a random sampling of 35,849 patient visits to 364 emergency departments, weighted to represent all emergency visits for 2006.
A total of 30.5 percent of emergency departments achieved the triage target for more than 90 percent of their patients, and 13.8 percent of emergency departments achieved the triage target for 90 percent or more of patients needing care within an hour. Less than half (47.7 percent) of emergency departments admitted 90 percent of patients needing admission to the hospital within six hours, and less than one-quarter (24.5 percent) of emergency departments admitted 90 percent of patients needing admission within four hours.
The National Quality Forum (NQF) has proposed quality standards for emergency departments, including measures of emergency department wait times and the visit length for admitted patients. While excess length of visit has been defined as four hours in the United Kingdom, four to six hours in Canada and eight hours in Australia, the NQF has yet to define a target length of visit for the United States.
“These delays in care and in moving admitted patients into the hospital are connected to systemic issues within hospitals, such as admitting procedures and prioritization of non-emergency department admissions,” said Dr. Horwitz. “The optimal length of visit for an admitted emergency patient is unclear. However, nobody would argue that people who need to be seen within one hour of coming to the emergency department should wait longer than that, and that is what’s happening at ERs around the country.”
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 28,000 members. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.
