Pulse Report 2010: Recession, unemployment, insurance losses increase pressure on ERs, patients

Nation's Emergency Physicians Predict Conditions Will Continue to Deteriorate

Average length of stay in the nation's emergency departments increased to four hours and seven minutes, and the nation's emergency physicians are very concerned about patient safety being jeopardized by long wait times.  Press Ganey's Pulse Report 2010, released yesterday, confirms what the American College of Emergency Physicians has reported previously: The recession, high unemployment and insurance losses are increasing pressure on emergency departments and their patients.  

Dr. Angela Gardner, president of the American College of Emergency Physicians, assessed the report's findings:

"The report finds pockets of good news, such as shorter times overall in Nevada, but nobody can possibly call a national average of more than four hours in the emergency department something to cheer about.  Last year the GAO reported that even patients who need to be seen in 1 to 14 minutes are waiting an average of 37 minutes for care.  Emergency physicians have become masters of improvisation and troubleshooting under extreme conditions, but the fundamental problems in our emergency departments remain unsolved.  

"Hospitals need to stop boarding admitted patients in the emergency department and get them to the appropriate inpatient floor quickly.  That is what's best for the admitted patients but it's also what's best for the patients suffering in the waiting room.  The full capacity protocol (http://bit.ly/9c44JH) has been proven effective in numerous emergency departments, but many hospitals continue to resist implementing it.  That's bad for patients.  

"Policymakers and the public should also have no illusions that the recently passed health care legislation is going to decrease ER use.  Massachusetts, which enacted health care reform in 2006, has seen an increase in emergency department visits, with no decrease in patient acuity.  It proves that health care coverage is no guarantee of health care access.  

"Hospital emergency departments continue to close, which reduces access to emergency care still further.  More patients plus fewer ERs equals longer wait times.  Nearly one-quarter of hospitals report periods of ambulance diversion because they are over capacity.  A longer ride to the hospital is not good medicine.

"This report is yet another wake-up call that health care reform has yet to address the acute care needs of 123 million emergency patients a year.  They may report being satisfied with the care they are receiving in the ER, but emergency physicians are dissatisfied with an average time in the emergency department that is nearly equal to a coast to coast airplane ride."