Best practice for this measure, Schneider says, is less than one hour. Thirty hospitals exceeded this time.
These time points were reported as part of a Centers for Medicare & Medicaid Services pilot program, announced Aug. 16, 2010, for patients who were sick enough to be admitted, and who were discharged during the first quarter of 2011. The data were posted in mid-April.
Reporting for all hospitals, based on a 2% pay-for-performance incentive, began Jan. 1, 2012, along with a third wait time measure (ED-3) for patients treated and released, and eventually, for determination of payment.
Schneider, an emergency room physician in Rochester, NY, says that while she's disappointed only 74 hospitals volunteered for this first round of reporting, emergency room physicians around the country are delighted that these wait times are now publicly reported.
"This is the first public look, and we're thrilled," Schneider says. "It says that CMS is finally paying attention to what we believe is the most important patient safety issue in all of emergency care: the issue of patients being boarded in the ED and staying for extensive periods of time." This issue was not only hidden from the public, she adds; "it was hidden from hospitals as well."
Some hospital leaders think that having patients wait three to four hours "is horrendous, but in other hospitals, three to four hours is a miracle. In those places, patients may spend two or three days waiting for a bed. There's a terrific spread," Schneider adds.