Should you post, text your ED wait times?
October 1, 2010
Should you post, text your ED wait times?
Hospitals are getting techy
A lot of hospitals are doing it these days posting their emergency department wait times on bulletin boards, on their websites, or even through text messages. Sandra M. Schneider, MD, FACEP, president-elect of the American College of Emergency Physicians (ACEP) and professor of emergency medicine at University of Rochester (NY) Medical Center, says she sees many hospitals posting their wait times, specifically the time to be seen by a clinician. She's not aware of any hospitals posting total or average treatment times. Schneider also practices internal and emergency medicine at Strong Memorial Hospital in New York.
The main reason she says hospitals are doing this is consumers' perception of the crowded ED and waiting long, frustrating hours to see a doctor an accurate perception, Schneider says. However, notorious ED wait times aren't due to too many patients, as most consumers believe, she adds. The reason is "inpatient boarders" patients already admitted with test work and paperwork complete waiting for transfer to a bed.
What the public doesn't know is that while EDs are crowded with these boarders who take up many acute beds, the department has the capacity to see less-acute problems (sprained ankles, broken bones, etc.), she says.
Because of the popular perception of long ED wait times, many patients are choosing to visit urgent care centers instead of hospitals, she says. So while "many people do believe that they are helping out the emergency department, in actuality what they are doing is diverting patients that we could see that would pay for their services to another setting."
Hospitals posting and advertising their ED wait times often are doing this to compete with these urgent care centers, she says. If a patient is experiencing a heart attack or stroke, he or she is probably not going to stop to think about the wait time in the hospital. But a person who has a sprained ankle "might sit down and look at the emergency department and decide which one they are going to go to based on how long they are going to wait," she says.
"In part, these wait times are a way for the emergency department to let the public know that while there is crowding, that if they come in with a relatively minor complaint in certain institutions, you can get seen and get in and out fairly quickly," she says.
Another thing hospitals nationwide are doing is putting a doctor in the triage area, she says, "so as soon as you come in, you see the doctor right away." The doctor can order tests; treatment such as pain medication; X-rays; and blood draws. The problem still is that patients end up in the waiting room until a bed is available for a more comprehensive assessment. Bed availability, she reiterates, is the problem.
Is having a doctor at triage versus a nurse a significant benefit? "I think in certain settings, they can be very significant. Those settings are again where the emergency department beds are very crowded by the boarders. It also is very effective if you have a lot of minor care patients," she says.
In most cases, hospitals are posting wait times on their websites, she says. With some hospitals, patients can text to find out the wait time, and at others, patients can text the hospital while on their way and can be put in a queue, much like a restaurant wait list. A hospital in Scotland has wait times visible when you enter the ED and a ticker appears if anything happens that could delay your care, such as a major car accident. Patients have been very pleased because they are apprised of what's going on, Schneider says.
Another institution is texting patients the day after they've been to the hospital to remind them about things such as an upcoming appointment or discharge instructions. "I think that's a clever use of social media," she says. She predicts an increase in the use of social media and digital communication to contact patients, as well as apps to help determine if you should go to the ED.
There are caveats to posting wait times, though, she says. Wait times are always subject to change if an influx such as a major car accident comes to your door. And patients may not consider that the wait time does not mean the time to treatment.
Currently, hospitals are posting wait times to be seen by a doctor but, she says, one of the Centers for Medicare & Medicaid Services' proposed quality measures for 2011 is how long patients spend in the emergency department. She expects subsequent standards benchmarking your times versus other hospitals' to come as well.
A lot of hospitals are doing it these days posting their emergency department wait times on bulletin boards, on their websites, or even through text messages.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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