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Speed of ED Care Goes Under Quality Microscope

Cheryl Clark, for HealthLeaders Media, July 28, 2011

It has to be done because ED care, arguably the most fast-paced and most vulnerable part of a hospital's operation, should be a place where everyone who says a word or phrase means the same thing, so care can be measured and compared as it is or is about to be in most other parts of healthcare services. There must be consistency.

That's especially important because over the next two years, CMS expects hospitals to begin tracking and reporting their median times for two National Quality Forum-approved benchmarks for emergency care:

  1. The number of minutes between the time the patient arrives at the ED to the time they depart the premises of the ED to be admitted to the hospital.
  2. The time between the moment a decision is made by the ED physician to admit the patient to a hospital bed to the time the patient departs the ED and is actually placed in an inpatient bed, a period sometimes referred to as "boarding."

At some point, the results will become public on hospitalcompare.hhs.gov.

For now, there is no payment or penalty tied to this reporting, but that will probably come. 

CMS has not defined the terms for these EDs. So these groups are trying to gather consensus so that everyone is on the same page.

"We want CMS to be aware of the fact that many patients in hospitals around the country are spending exorbitant amounts of time in the ED before they can get to a hospital bed," said Schneider.

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