Wait Times in Emergency Departments Surge

Patients last year averaged a record of four hours and seven minutes spent in the nation’s emergency departments—a four minute increase over 2008 wait times, and a 31-minute increase since reports were made available in 2002, according to a new review from Press Ganey Associates, Inc.

Press Ganey’s 2010 Emergency Department Pulse Report: Patient Perspectives on American Health Care, is based on evaluations of more than 1.5 million patients treated at 1,893 hospitals in 2009.

Utah had the longest wait, with an average emergency department time of 8:17—nearly an hour and a half longer than the state’s average time spent last year.

Iowa had the shortest average time spent at just under three hours (2:55), followed by South Dakota (2:59), North Dakota (3:07), Nebraska (3:08) and Minnesota (3:11). More than half the states were able to improve wait times or keep increases to a minimum. Nevada made the biggest improvement in 2009, reducing average wait time by 66 minutes since 2008.

“Although the overall national average wait time increased slightly, what we found encouraging is that 32 states had either reduced wait times or held increases in wait times to five minutes or less over the previous year,” says Deirdre Mylod, vice president, hospital services, Press Ganey. “Some states have done really well in keeping emergency department times in check, despite growing challenges of higher patient volumes and understaffing. But there’s still a long way to go to make visits to the emergency department much more efficient for patients.”

Despite longer waits, patient satisfaction with hospital emergency departments stayed about the same in 2009, continuing a five-year upward trend. Press Ganey says providing a patient with good emergency department experiences requires communication. Patients are willing to wait for care as long as they are kept informed about wait times. Patients who waited more than four hours, but received “good” or “very good” information about delays were just as satisfied as patients who spent less than one hour in the emergency department. Patient evaluation of communication about delays is identified as a key driver nationally of satisfaction.

 “Patients would, of course, prefer a more efficient process,” says Mylod. “But good communication helps them understand the processes within the emergency department environment and shows them that staff has not forgotten them. Frequent, proactive communication improves both the quality of patient care and the manner in which patients perceive their care.”

Many hospitals are instituting procedures such as whiteboards in exam rooms to keep patients informed about treatments or delays. Also, welcome letters or pamphlets provided by the hospital help patients understand the process of triage, and prioritized treatment.

A long wait time might not be indicative of the emergency department’s performance. Instead, it could be a symptom of a larger patient flow issue in the hospital that keeps the patients in the emergency department when inpatient beds or testing equipment are not readily available.

Another factor impacting patient satisfaction with emergency departments is the time of day patients arrive. According to the report, patients who arrive between 7 am and 3 pm evaluate their care much more favorably than those who arrive after 3 pm. Patients who arrive in the emergency department on Monday and Tuesday rank lowest in terms of patient satisfaction, while Saturday and Sunday evaluations of care are the highest.

Among metro areas, patient satisfaction with ED care was highest last year in Madison, WI, which failed to make the top metro area list in 2008. Miami-Fort Lauderdale-Pompano Beach, FL, which was No. 1 in patient satisfaction in 2008, fell to sixth last year, but 2009 marked the third consecutive year it made the list.