State-by-state ER wait time calculated

Al Rosen

Staff member
Super Moderator
#1
From USA Today:
The average wait a patient has in U.S. emergency rooms is 3.7 hours, or 222 minutes, according to a new study. The state-by-state listing of average wait times shows that in places such as Arizona, for instance, patients spend more than twice as much time in the emergency department as those in Iowa and Nebraska.
Complete story.

I wonder how this compares with the rest of the globe.
 
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Jen Kirley

Quality and Auditing Expert
Staff member
Admin
#2
It's like applying the "Bill Gates walks into a bar and then the average income is $.5 million."

I went to the emergency room after breaking my leg and ankle while walking my dog. I experienced no wait because it was mercifully not busy that night. The service was top-rate.

In contrast, on a later date my daughter went in and we waited for hours because there were a number of people there and the intake person switched her name somehow, so they called someone else (who naturally didn't stand up). That mistake cost us about an hour before I went to the window and asked when it was going to be our turn. :rolleyes:

So it's largely affected by region as well as many other factors...day and time, holiday weekend, etc.

Someone remarked that it's faster to get a pizza delivered than an ambulance. That's sad.
 

Wes Bucey

Quite Involved in Discussions
#3
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.)
 
Last edited:

harry

Super Moderator
#4
After reading what had been posted, I begin to have a better opinion of government sponsored medical services in my country. Here's my experience for comparing notes.

Some thirty years back, my parents met with an accident. It took the hospital ages to attend to them and finally my mum lost a leg - need to be amputated partly because of the hospitals slow response. The incident taught me a lesson - never ever get yourself landed in a hospital.

Until today, the average waiting time in that particular hospital, known as the general hospital or the biggest in the state is about 3 hours to half a day. A friend of mine was the deputy director some time back. I tried not to call him because your call will be passed around till the line gets disconnected or you get no response at all.

Two months back, my son met with an accident and broke his collar bone. I decided to send him to the newer 'district' hospital instead. I was in for a surprise. Service was good and waiting time was minimal - better than most private hospitals. From registration to preliminary check by the medical officer, X-ray and then seeing the doctor, dressing and finally collecting some medicines took just slightly under 3 hours.

Subsequent follow ups met with the same standard of service also. There are two reasons contributing to the above. First, people generally have a negative impression when you mentioned its a district hospital - therefore there are less patients unlike the general hospital.

Second and the most important is that this district hospital is in the process of implementing ISO 9001, target certification date is end 2006. It's 'ISO' in action - no wonder everything from registration onwards is so systematic. With flow charts pasted on notice boards, you practically know what to expect next and also the whole process you need to go through.

I now have a much better impression of our local medical service.
 
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