Just an observation.
Cautionary warning about bias and/or expertise:
I am a long-time member of the Institute for Healthcare Improvement (ihi.org)
There are several factors which affect ER total visit times (note there is a difference between "visit time" and "wait time" and "first contact with healthcare professional (triage) time.")
Definitions:
Visit time: time from sign in to exit (out the door or admitted to hospital)
Wait time: time from triage to treatment beginning
triage time: time from sign in until contact with triage professional (nurse or doctor) who assesses the immediacy of patient's need.
Causes for delay and high number of patients clogging the system (not prioritized and certainly not all reasons): Almost all waits have to do with sheer numbers of patients and the waits due to differences in severity of need. ERs are at fault when understaffed despite historical usage and when triage is poorly done. Minor errors (similar to Jennifer's experience) are often due to receiving clerks being poorly trained volunteers rather than trained paid employees.
- Patients do not have regular doctor to see for ANY health care and so come to ER for all first care - sheer volume of patients
- Reimbursement policies of 3rd party payers - easier to see health care professional even with long waits at ER than getting to a physician who is on the reimbursement plan
- Patients with or without insurance whose doctors have long lead times for appointments (note many doctors are attempting to ameliorate this problem by offering "walk-in hours" before common work times for folks so they won't have to take off time from work for a regular appointment for minor stuff or be forced to visit an ER in off hours from work.)
- Many ERs are not "trauma centers" and are unprepared and unstaffed to handle major traumas which will disrupt care for all remaining patients
- Many ERs are constrained by union contracts and other considerations to making any drastic changes in manner of running the processes
- Many third party plans reimburse treatment, but not preventive care, thus conditions may deteriorate to crisis stage before treatment instead of preventing them from happening in the first place (does this sound suspiociously as if health care folks never heard of Deming or his theories? "Prevention versus Detection")
In my personal experience for me and members of my family over the last 60 years, a dispassionate look at our various reasons for going for treatment through the eyes of a triage nurse would say we got treatment in time appropriate to the seriousness of our condition.
Some examples:
My dad ended up with a fishing lure hook (barbed) through his ear in far north Wisconsin and we ended up at a teeny tiny hospital with only two doctors in the entire town. Half hour row back to car on shore, half hour drive to town with hospital, two hour wait while doctor delivered a baby. Five minutes of treatment (cut the barb, remove the hook, clean wound, one stitch, tetanus shot, "be careful and glad it was an ear, not an eye. Goodby!" and out the door)
My daughter broke an ankle in gymnastics practice - total elapsed time from fire department ambulance call to out the door with cast and crutches - four hours.
Me - heart attack scare - I drove myself five minutes to hospital (dumb, huh?) and within first five minutes I had one aspirin, laid on table and hooked up to monitors, one hour until they came around to see if I had an insurance card and put a wrist band on me. Three hours later - declared false alarm and sent on my way.
Me - fell off ladder late Friday night, did my own first aid for self-diagnosed sprained ankle (WRONG!) drove to Cook County hospital following morning using other foot to operate accelerator. Saw triage nurse within 20 minutes, waited 3 hours before being taken for Xray, another two hour wait for doctor "look see" and diagnosis of several broken bones, immediate cast, set of crutches, one minute of instruction in using crutch and out the door.
Returned same place two weeks later for new cast, triage sent me to casting technician (who did a better, neater job than original physician) and out the door in forty-five minutes. No doctor viewing (time difference may have been due to time difference between Saturday for first visit and Wednesday for second visit.)