Patients spent an average of 243 minutes in EDs in 2008, two minutes less than in 2007, according to a report by Press Ganey (http://bit.ly/F6i2R). The report analyzed data collected from 1.4 million patients who visited EDs nationwide. The shortest average wait time was in South Dakota (172 minutes) and the longest was in Utah (408 minutes). Two states considerably improved their ED wait times compared with 2007-Virginia patients spent 23 fewer minutes and Maryland patients spent 14 fewer minutes. But despite generally long wait times, overall patient satisfaction has improved, mostly because ED staff are communicating better with patients about delays.
The top 10 metropolitan areas in patient satisfaction are Miami, Florida; Detroit; Philadelphia; Pittsburgh, Pennsylvania; Boston; Chicago; Baltimore, Maryland; Houston; Dallas; and New York City. Patient satisfaction is highest between 7 AM and 3 PM and lowest between 3 PM and 11 PM. Not surprisingly, patients who spend more than two hours in an ED are less satisfied than those who spend less time. But when patients receive "good" or "very good" information about delays, satisfaction improves, despite the long waits. Comfortable waiting rooms also improve patient satisfaction and, based on patient comments, so does the presence of nurses.
"Nurses are critical in the operation of EDs, in keeping patients flowing through them and in influencing patient satisfaction," says William Briggs, president of the Emergency Nurses Association and trauma program director at Tufts Medical Center in Boston. "It all comes down to what people want in EDs: human interaction."
Another report addressing ED capacity in 2007 was recently issued by the Centers for Disease Control and Prevention's National Hospital Ambulatory Medical Care Survey (http://bit.ly/4cqjWH), which found that because of overcrowding, 62.5% of ED patients were "boarded" for more than two hours until a bed opened up. Large EDs (those that log more than 50,000 visits yearly) were more likely than small EDs (less than 20,000 visits) to "board" patients for more than two hours; to have a bed coordinator and clinical decision unit; and to use bedside registration, computer-assisted triage, and zone nursing.
Carol Potera