by Judith Lavelle
Wait time is pivotal in emergency medicine.
I live in Boston, a city saturated with universities and flush with hospitals, so being able to access state-of-the-art medical treatment rarely worries me. Still, it should concern all of us that hospitals around the US are closing their emergency departments (citing large overhead costs) even though, as the The New York Times reports, patient demand is on the rise.
Last Monday, I was one of those patients. I’m doing fine now, but feeling poorly then, I landed in the emergency department waiting room at Beth Israel Deaconess Medical Center in Brookline. The staff was attentive, and my wait was under an hour. While Brookline is better off than many communities with heavily-burdened ERs, my experience got me thinking about how some departments speed up their response times and why some do better than others.
First, my inevitable history lesson: while there were a whopping 129.8 million ER visits in 2010, emergency medicine as a medical speciality is relatively new. Emergency rooms began appearing with the onset of stricter standards for hospital care at the turn of the century, and the first emergency medicine residency programs were established as recently as the 1960s and 70s. Before that, patients who were lucky enough to receive immediate medical care were likely to have their doctors come to them during a house call. Now, hospitals have revived the let-us-come-to-you strategy within their ER waiting rooms.
When patients arrive in the ER, they are quickly examined by triage nurses, who determine when the patient will be seen based on the severity of their condition. If patients have to hang tight for a bit, many ERs will begin the diagnosis or treatment process right in the waiting room. If they didn’t already take care of it in triage, hospital staff will collect a patient’s blood and urine samples and take his vital signs (like blood pressure, temperature and heart rate). This way, when a bed finally opens out or a physician becomes available, the staff will already have the results of the tests to refer to. If doctors are available but beds or exam rooms are not, patients may also be evaluated in the waiting room by doctors who can prescribe painkillers and other time-sensitive medications before the staff can provide more intensive treatment.
The CDC reported in 2010 that a quarter of ER patients are seen in under 15 minutes, and data from ProPublica states that the average national wait time is 28 minutes–but this reflects a wide range of patients appearing at various times of the day with all kinds of conditions. Nonetheless, the data reveals that you may wait the longest to receive care in Washington, D.C. but spend only a short time in a Wyoming ER waiting room. To get a better sense of how long patients wait in specific areas of the country, you can check out ProPublica’s news app, which lets you search for average waiting times in local ERs: