Emergency Room Delays May Put Patient Lives At Risk
New research suggests that about a quarter of patients who need emergency care are not being seen in a safe amount of time due to America’s increasingly crowded hospital emergency rooms. Delays could have a ripple effect, resulting in higher rates of morbidity and mortality in hospitals.
According to a study published in the November 9 issue of the Archives of Internal Medicine, delays in emergency room treatment are worsening across the country, with just over 75% of patients being seen within the recommended time frame. Researchers found that the number of patients being seen in a timely manner is decreasing by about 0.8 percent every year.
The study looked at 151,999 emergency room visits between 1997 and 2006, dividing visits into categories based on the level of severity of the emergency. Overall, the researchers found that 75.9% of all patients were seen within the recommended time. In 1997 that number was 80%.
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In an editorial accompanying the study, Dr. Renee Y. Hsia and Dr. Jeffrey A. Tabas from the University of California, San Francisco, noted that there are a number of potentially serious consequences from emergency room delays. Hsia and Tabas described the overcrowding as a worsening problem that could cost lives, calling for a variety of solutions.
“Crowding in the ED (emergency department) has been associated with poorer process measures, including delays in treatment of pain, delays in antibiotic treatment for community-acquired pneumonia and decreases in the satisfaction of patients with their ED stay and hospitalization,” Hsia and Tabas said in the accompanying editorial. “There is also increasing evidence to suggest that ED crowding is associated with poorer clinical outcomes, such as increased in-hospital morbidity and mortality.”
Medical professionals recommend that emergent patients, the patients in the direst need of medical attention, be seen between 0 and 14 minutes of arriving at a hospital seeking treatment. The study found that these patients were the least likely to be seen on time. Only 56.6 percent of patients in the most need of medical attention were seen in less than 14 minutes, compared to 100% of semi-urgent patients being seen in the recommended time of one to two hours.
Researchers said that the increases in emergency room wait time have accompanied increases in the number of people going to hospitals for all manner of ailments, and high bed occupancies have decreased the number of beds available for patients most in the need of care.
Experts have recommended a number of emergency room changes that hospitals can make to decrease wait times, including:
- Condensing the number of questions asked by triage nurses, and having those nurses assign the patient to their next nurse.
- Having patients see the doctor and nurse at the same time after passing through triage, instead of one after the other.
- Equip emergency rooms with bedside supplies that address the most common reasons for emergency room visits.
- Have information such as patient identification and insurance collected at bedside, once the patient is already being seen.
DavidApril 11, 2010 at 8:48 am
My wife went to a local emergency room after visiting our family doctor and was told she needed imediate emergency treatment. She refused to go by ambulance and I drove her there. The doctor in the mean time called ahead and advised she was coming and advised the emergency room staff she needed treatment immediately upon arrival. Upon arrival I presented a copy of her notice to the hospital fro[Show More]My wife went to a local emergency room after visiting our family doctor and was told she needed imediate emergency treatment. She refused to go by ambulance and I drove her there. The doctor in the mean time called ahead and advised she was coming and advised the emergency room staff she needed treatment immediately upon arrival. Upon arrival I presented a copy of her notice to the hospital from the doctor and was informed we had to wait in the emergency room waiting room. My wife sat their for 15 minutes before someone came in to take her into the emergency room. In the emergency room the staff nurse came in and did the normal things, blood pressure, pulse, and ask about her complaint. (chest pain). She was asked on a scale of 1-10 about her pain and she replied a 4-5 and made it quite clear she had pressure and pain in her chest. The nurse came in several time after that and ask her how her pain was and she said it was getting worse. We were told the doctor would be in in a few minutes each time the nurse came into the room. I even complained to the nurse that this emergency room wasn't this slow with a patient because I use to come to that hospital with a local ambulance service that I worked for as an advanced EMT. I called a friend to come to the hospital and sit with my wife this took some time and now we were almost one and one half hours into the wait. Upon our friends arrival I went to the office of the hospital advocate and complained to her about my wifes wait in the emergency room and by the time I returned she had several people in the room taking care of her. I contacted the hospital administrator and was informed by recent letter and I quote "I have received your case and the concerns expressed by you and your husband. I found that you were triaged quickely and appropriately, but I agree that you waited quite a while for medication to treat your symptoms. Please understand that consideration must be given for any medications you may have been given prior to you arrival must be considered prior to your arrival at Porter. As your husband is aware the ER is a complex atmosphere, where there are issues which come up quite quickly and need to be attended to and that takes time." Yet my observations were ignored, that a doctor was seen enjoying his lunch and writing out discharge orders for other patients. I was told that there was only one doctor on duty and a supposed triage nurse on duty that day and yet the emergency room was full of patients. This hospital has cut back on staff after announcing they will build a new hospital outside of town and I have seen staff cut backs in the nurses on the hospital floors as well. I do not believe anyone has to wait for a doctor for almost two hours in an emergency room. This was once a well staffed hospital and now is seemingly a place where not only myself but others believe is a hospital on the down hill slope of being highly dangerous towards it patients.
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