How Long Will You Wait in the Emergency Room?

If you have a medical problem requiring a visit to the emergency room, how long you must wait depends on the severity of your condition, and many other factors beyond your control, such as time of day or night, location of the facility, the demographics of other patients and the medical staff on hand.

In an effort to help ER patients get the best emergency room experience, the investigative news site ProPublica has introduced ER Wait Watcher, an interactive news application. Using nationwide data from the federal government, it shows how long it takes, on average, to see a doctor or other licensed professional at hospitals near you, and how long it takes to drive there.

“If you think you’re having a heart attack, or if you’ve suffered a serious injury,” ProPublica makes clear, “you should not use ER Wait Watcher. Please call 911. The ambulance will take you to the closest hospital, and won’t be as affected by traffic because it can speed and run red lights.”

Otherwise, the new app can help you get better treatment faster. It enables you to see, for example, that sometimes the hospital closest to you might not be the best option because of long waiting times. Traveling farther might get you seen sooner. And when you’re scared, in pain or need to be admitted to the hospital, the less time you wait, the happier you are and, usually, the better the outcome.

The app uses data from the Centers for Medicare and Medicaid Services (CMS) for “Timely and Effective Care.” The measures are based on a year’s worth of data that CMS updates quarterly. It includes averages for how long patients tend to wait before seeing a doctor, how long they spend in the emergency department before being sent home or admitted to the hospital and how many leave without being seen at all. The data are provided voluntarily by hospitals, which have a financial incentive to participate.

The data reflect what researchers say are important quality measures for emergency departments. From a patient’s perspective, it’s pretty much just waiting time – the time from when you walk in the door to when you see a doctor. Other measures, such as length of stay at the hospital, may vary more depending on condition (a skull fracture usually takes longer than a dislocated elbow) or on other patients (some hospitals treat sicker patients). But how fast you’re seen can be compared across hospitals.

In the last 20 years, according to ProPublica, the number of ER patients has increased, leading to overcrowding. Ambulances are turned away more frequently, and it’s more difficult to find specialists to take emergency calls.

Longer wait times, however, don’t always indicate worse care. ERs that see more patients with behavioral health problems such as alcohol abuse might have much longer wait times because it can take hours for someone to sober up enough to be safely discharged. So the app also includes patient satisfaction scores and other hospital quality measures.

Still, overcrowding isn’t just annoying, and doesn’t affect only the people with minor complaints. ProPublica refers to a study of almost 1 million admissions to 187 California hospitals that found that patients who were admitted after going through a very crowded emergency room were at 5% greater odds of dying than those admitted after passing through a less-crowded emergency room.

Some emergency departments post waiting times on their websites, on billboards or on smartphone apps. If your situation isn’t life-threatening, that can be useful planning information and, says ProPublica, might help distribute patients more effectively and improve patient satisfaction.

“But that information may not be reliable, or useful for comparing hospitals,” ProPublica warns. “On their own websites, hospitals are free to advertise any definition of ‘waiting time’ they choose. While one hospital could choose to count the time from when a patient arrives to when she is evaluated by a doctor, another could decide it’s when a patient is seen by a triage nurse, or receives a welcome from the hospital greeter.”

So to address such discrepancies, the CMS established standard definitions and a common metric for hospital comparisons. “Waiting time” is measured from when a patient walks in the door to when he or she is evaluated by a doctor, physician assistant or nurse practitioner.

To see a state-by-state chart of waiting times, link to ER Wait Watcher here.

The chart explains the average time patients wait in emergency rooms before one of four things happen: They see a doctor, they’re sent home, they’re given pain medications for a broken bone or they’re admitted to the hospital. For each measure, lower numbers are better.

Remember, though, that very small differences between hospitals for a given measure are unlikely to correspond to noticeable differences in the real world.

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