ERs on the critical list: Wait times get longer across the country

Emergency room wait times are on the rise throughout the United States in part due to more patients obtaining insurance under the Affordable Care Act (ACA) and 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 hospitals to reevaluate their procedures and make every point of the process more efficient, according to WBALTV11.

A 2014 study in Florida blamed higher ER patient volume for the longer waits as well as more patients using the emergency department for dental care.

But recent media coverage of longer wait times in upstate New York, California and Chicago attribute the influx of patients to the healthcare reform law. While many thought the ACA would mean the ER would have fewer uninsured patients seeking treatment for minor illnesses, Daniel Reaven, M.D., head of Northwest Community Hospital's emergency department 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 ER visitors with nonurgent or chronic problems to manage their own care and plans to open an urgent care center to treat non-emergency issues, according to WBALTV11.
  • Ingalls Memorial Hospital in Chicago, which has the lowest ER wait times among Cook County's busiest emergency departments, uses a "direct-to-bed" approach that brings patients directly to ER beds so there are no delays in the waiting room, according to a Chicago Tribune community contribution piece. Another time saver is the use of documentation scribes that handles 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 ER. Times are updated as urgent emergency cases arrive, according to the Manteca Bulletin.

Another successful strategy: Lean manufacturing. Stanford Hospital and Clinics in California used the principles to cut ED wait times by 17 percent even though the ERs treat 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, FierceHealthcare previously reported.

To learn more:
- read the WBALTV11 report
- here's the first and second Chicago Tribune articles
- check out the Manteca Bulletin story
- read about The Buffalo News report on ER wait times in New York