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Speed of ED Care Goes Under Quality Microscope

Cheryl Clark, for HealthLeaders Media, July 28, 2011

Frankly, one of the concerns is that some hospitals have been taking some advertising liberties, which confuses the issue even more.

Suzanne Stone-Griffith, RN and a member of both coalitions said that "there's a growing number of ad campaigns out there, with lots of spinning going on. They'll say, 'We have a 30-minute promise, that if you come to our ED you'll be seen in 30 minutes.' Well, what does that mean? Be seen by whom?" Or seen by a clerk at a sign-in table?

As of now, two important events have taken place:

1.     A coalition of physicians and nurses who make up the Emergency Department Benchmarking Alliance have published a lengthy paper this month in the Annals of Emergency Medicine that precisely defines

  • Timestamps, such as arrival time, provider contact time, admit decision time and departure time.
  • Time intervals, such as door-to-doc or length of stay, or treatment space to provider time.
  • Subcycle intervals, such as EMS offload interval, triage interval, or laboratory interval.

2.     As reported this month, the Emergency Nurses Association, in collaboration with the American College of Emergency Physicians, the National Association of EMS Physicians and six other emergency care specialists, developed a consensus statement, settling on definitions for six terms on whose definitions they all could agree:

  • What is an ED
  • What is an ED arrival time
  • What is an ED offload time
  • What is the ED transfer of care from pre-hospital providers time
  • What is an ED triage time
  • What is an ED treatment space time

Only by agreeing on these and other definitions can hospitals get truly serious about reducing wait times. And, only then can providers be sure they're doing everything they can to measure and improve the quality of emergency room care.

I think in time, we'll look back and say that by defining what we expect of emergency room care, we will not just reach better benchmarks, we will also save a lot of money, because we will have reduced the severity of outcomes, while saving many lives.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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