All Entries Tagged With: "Emergency department"
AHRQ finds nearly 20% of ED patients are uninsured
The AHRQ announced yesterday that a new data analysis of the The Nationwide Emergency Department Sample shows nearly 1 in 5 emergency department patients are uninsured. The data are taken from 2006. Kathleen Sebelius, secretary of the department of Health and Human Services, said that this statistic highlights the burden that uninsured patients are placing on the nation’s emergency system. Faced with no other option for care, uninsured patients use the emergency department for sicknesses that a primary care physician could handle. Additionally, uninsured patients may wait longer to seek care at the emergency department because they have no option for primary care, which exacerbates their health problems.
“Our health care system has forced too many uninsured, rural and low-income Americans to depend on the emergency room for the care they need,” said Secretary Sebelius in a press release. “We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies.”
Whenever I find data about emergency department usage, I’m never really surprised. But, as Secretary Sebelius says in her above statement, when will the nation take action to fix this problem that has crippled our emergency departments and treated the uninsured as second class citizens? Perhaps legislation we see coming from the federal government in the coming weeks will provide some sort of solution.
Texting informs public of wait times at South Carolina EDs
Trident Health System, based in Charleston, SC, has launched a new service that allows prospective emergency department patients to text a certain number and find out how long of a wait they are in for at three different emergency departments (ED) in the area, reports The Post and Courier. Here’s how it works: A patient decides he or she wants to go to the ED for immediate care. He or she texts “ER” to specific number, and in return that person receives a text message asking for the zip code of where he or she is located. After that, another text message arrives listing average wait times at area emergency rooms. The “average wait time” represents the previous four hours and is updated every 30 minutes.
Patients can then choose to drive to an ED that is further away but may have a shorter wait time, or an ED that is closer but with a longer wait time. Whatever the situation, it gives patients more information to make their choice of ED.
Of course the health system advises those patients suffering a true emergency who would not be able to drive themselves to the emergency department to call 911. Oh, and standard text messaging rates apply.
Would your hospital ever consider offering a technology-based service like this to let patients know about ED wait times? Read the full article here.
Patient satisfaction on the rise at EDs across the country
A new report from Press Ganey shows that despite reports of overcrowding, patient satisfaction scores for emergency departments (ED) actually rose last year, and the average national time spent at EDs dropped by two minutes, to 4 hours, 3 minutes. The 2009 Emergency Department Pulse Report: Patient Perspectives on American Health Careanalyzed 1.4 million patient responses about their ED stays at more than 1,700 EDs throughout the country. The increase in patient satisfaction may be related to EDs better communicating wait times with patients.
In an article with HealthLeaders Media, the spokesperson for the American College of Emergency Physicians, Leigh Vinocur, MD, said that she’s not surprised to see the rise in patient satisfaction scores because patients are frustrated with their inability to see their primary care physician (PCP) in a timely manner, as well as the wait times associated with a PCP referring patients to any specialists or for further testing. Patients leave the ED having seen a doctor and for the most part, receiving any testing necessary.
Other points that came out of the report: Staff scheduling is important. Patients who visited the ED between 7 am and 3 pm report being more satisfied with their visit to the ED. This is probably because by the time it’s the afternoon, there are more patients who have arrived, and less staff members to take care of them. Also, patients take the comfort of the waiting room seriously—those who felt the waiting room was not comfortable did not rate their overall stay very well.
For more information about the report, visit www.improvemyer.com
GAO says ED overcrowding a big problem
In a report released on April 30, The U.S. Government Accountability Office (GAO) said that national data collected in 2006 indicate that most of America’s emergency departments are overcrowded, and the problem continues to worsen. The report’s authors also examined relevant articles and factored those into its summary of problems with ED overcrowding, as well as interviewed officials from federal and state groups and research organizations.
Patients are waiting more than double the recommended amount of time to see a doctor (37 minutes, versus a recommended time of between 1 and 14 minutes). Additionally, 25% of hospitals went on diversion at least once during 2006. Last, patient boarding has increased in most urban settings and continues in other settings, due in most cases to a lack of available inpatient beds. Additional factors include less patient access to primary care physicians and specialists.
You can read the full report here.
Those of you working at hospitals with EDs are most likely not shocked by this report, and most likely have been asked on a local level to try to solve part of this problem. Have any creative solutions come from your discussions?
Urgent care centers prove their worth in wake of long ER lines
Lengthy wait times at emergency rooms (ER) around the country have given way to “urgent care centers,” alternatives to the ER for less severe ailments, reports the Los Angeles Times. In 2006, patients waited an average of 3.3 hours to be seen at the ER, according to a Centers for Disease Control and Prevention report. Urgent care centers offer those patients who do not have life threatening problems a chance to escape these long wait times and be treated medically faster than they would be by waiting to see a primary care physician.
The Urgent Care Association of America (UCAOA) reports that 8,000 urgent care centers existed as of 2008. However, these somewhat new options for care are for the most part unregulated. The UCAOA is drafting a list of what patients can expect at urgent care centers (hours, medical professionals who could work there, procedures that can be performed).
Insurers like the idea of urgent care centers because when patients visit urgent care centers, it often means insurers will not have to pay for what most likely would have been more costly ER visits. Many hospitals are scrambling to find ways to lessen ER wait-times for both patient satisfaction and patient safety needs. However, the LA Times article raises an important question—what if patients are unable to appropriately decide on the severity their symptoms?
Do you have any experience with urgent care centers in your community?
New Jersey hospitals feeling economic pinch
New Jersey hospitals, like many across the nation I would assume, are feeling the effect of a dwindling economy. Layoffs, delays in capital improvement projects, and more charity-care patients are a few of NJ hospitals’ woes, according to a report in the Philadelphia Business Journal. The New Jersey Hospital Association conducted a survey over the last two months involving 74 of New Jersey’s acute-care hospitals. Key findings include:
- 45 hospitals reported layoffs in 2008
- 21% anticipate layoffs this year
- 13% have instituted a hiring freeze
- 17% eliminated services such as clinics and inpatient psychiatric care
- 76% saw in increase in emergency department visits
Not surprisingly, the New Jersey Hospital Association says the cuts are affecting patient care. I’m guessing this is just an example of what’s happening across the nation. I’m curious to know how the economy is affecting your hospitals. How are cuts affecting patient care? How are they affecting you? Has your hospital managed to stay afloat, and how? What are you concerns for the upcoming months?
What to do with non-urgent ED patients
Emergency departments (ED) across the country are suffering from overcrowding. There are many reasons for the plethora of people in today’s EDs, from hospital closings to primary care physician shortage. At University of Chicago Medical Center’s ED, part of the problem was that 40% of the 80,000 patients who show up every year don’t need emergency care, according to a Wall Street Journal post. So the University of Chicago Medical Center decided to redirect those non-urgent patients to other local health clinics to receive care. United States Sen. Chuck Grassley (R-IA), among others, have questioned this method.
I know our readers must deal with crowded EDs every day. What do you think of this method? How does your hospital handle overcrowded EDs?
ED docs sue California
A group of emergency department (ED) physicians have filed a class-action lawsuit against the state of California, claiming the state’s low Medicare reimbursement rates are strapping EDs with long wait times and endangering patient safety, reports the Los Angeles Times.
Physicians say reduced reimbursement rates are placing an unfair burden on ED physicians, who must accept all Medicare patients under federal law. They say rising numbers of local hospital closures as well as the rising number of patients unable to find primary care physicians have greatly increased ED crowding. Specialists can also opt-out of on-call assignments, creating longer wait times for care.
These factors combined, they say, are creating a storm of poor patient care in which patients are dying as they wait for treatment.
