Many EDs Not Caring for Patients Fast Enough

Les Masterson, for HealthLeaders Media , September 30, 2009

Emergency departments are not caring for patients as quickly as recommended, according to a new study in the Annals of Emergency Medicine.

The study, called "United States Emergency Department Performance on Wait Time and Length of Visit," found that a mere 30% of EDs got the majority of their patients seen by a physician within recommended time frames and only 13.8% of EDs achieved the triage target for the majority of patients who needed to see a doctor within one hour.

"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, CT. "In addition, only 24.5% 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."

These figures were released as the National Quality Forum (NQF) is looking for changes to ED quality standards, including measures on wait times and the visit length for admitted patients. Though NQF has not defined a target length of visit in the U.S., the United Kingdom defines it as four hours, Canada suggests four to six hours, and Australia says eight hours.

"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 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."

Les Masterson is an editor for HealthLeaders Media.

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