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ERs on the Critical List: Wait Times Lengthen Across the Country

Hospitals try new strategies to treat patients faster

Since more people have obtained insurance under the Affordable Care Act (ACA), the number of visits to emergency departments (EDs) has increased. As a result, ED wait times are rising across the country and hospitals have implemented new processes and strategies.

According to FierceHealthcare, hospitals are pulling out all the stops to manage and treat patients sooner.

The longer wait times are so noticeable in Maryland that Kevin Seaman, director of the Maryland Institute for Emergency Medical Services, sent a letter this year to the Maryland Hospital Association asking its members to re-evaluate their procedures and make every point of the process more efficient, according to television station WBAL.

A 2014 study in Florida blamed higher ED patient volume for the longer waits, as well as more patients using the ED for dental care. But recent media coverage of longer wait times in upstate New York, California, and Chicago attributes the influx of patients to the health care reform law. While many experts thought the ACA would mean the ED would attract fewer uninsured patients seeking treatment for minor illnesses, Daniel Reaven, MD, head of Northwest Community Hospital's ED in Chicago, told the Chicago Tribune that he's seen an increase since the law took effect.

"Some of the patients we're seeing have actually given up their [ACA] insurance, and there are different theories why," Reaven told the publication. "But we're also seeing more people now, because they have new insurance plans and benefits that they didn't have before."

To cut wait times, hospitals have implemented new processes and strategies. Among the most successful:

  • Sinai Hospital in Baltimore works with frequent ED visitors with nonurgent or chronic problems to manage their own care and plans to open an urgent care center to treat nonemergency issues, according to WBAL.
  • Ingalls Memorial Hospital in Chicago, which has the lowest ED wait times among Cook County's busiest EDs, uses a "direct-to-bed" approach that brings patients directly to ED beds so there are no delays in the waiting room, according to the Chicago Tribune. Another time saver is the use of documentation scribes who handle paperwork so the attending physician can spend more time with patients.
  • Doctors Hospital of Manteca in California uses an online system that allows patients to "sign in" from home for an appointment at the ED. Times are updated as urgent emergency cases arrive, according to the Manteca Bulletin.

Another successful strategy: Lean manufacturing (a systematic method for the elimination of waste). Stanford Hospital and Clinics in California used the principles to cut ED wait times by 17% even though its EDs are treating more patients than the year before. And Kaiser Permanente South Sacramento used the technique to cut the average wait time to 19 minutes, less than half the national average of 58 minutes.

Source: FierceHealthcare, November 4, 2015.

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