Emergency rooms slow, Yale study finds

Hospital emergency departments are notorious for their long waiting times. But the problem is worse than previously thought, a Yale study found.

Patients who visited the slowest 25 percent of emergency departments waited on average two hours longer than those who visited the fastest 25 percent of emergency departments, the study revealed. In addition, only 25 percent of hospitals in the study admitted 90 percent of their emergency department patients within four hours.

The report, published Oct. 5 in Annals of Emergency Medicine, found that in a typical emergency department, one-third of severely ill patients waited longer than recommended at triage for treatment. One-fourth of admitted patients spent over six hours waiting for an inpatient bed.

Yale School of Public Health professor Elizabeth Bradley GRD ’96 , graduate student Jeremy Green SPH ’13 and Yale School of Medicine professor Leora Horwitz MED ’06 analyzed data from 36,000 visits to 364 non-federal U.S. hospital emergency departments. The results came as a surprise, Bradley said.

“The people who were told they need to be seen immediately or within the first 15 minutes — that was the group that was the least likely to be seen within their target time,” Bradley said.

She said that if the government mandated that hospitals publicize records of their emergency departments’ waiting times, it would force hospitals to be more efficient.

But faster treatment of patients, Bradley added, is not a guarantee for better quality of care. Part of the problem stems from the fact that hospitals do not properly address the problems plaguing their emergency departments, said Ian Schwartz, an emergency department medical director at Yale-New Haven Hospital.

“The hospital collectively makes a decision when things are overcrowded to put that risk in the emergency department,” Schwartz said. “So essentially all the overflow of the hospital sits in the emergency room.”

Crowded emergency departments are a part of everyday life at Yale-New Haven, two medical directors at the hospital said. EMS Medical Director Carin Van Gelder said the lack of access to primary care doctors affects treatment times at Yale-New Haven. But the Yale-New Haven emergency department, unlike others, never sends ambulances to a different hospital, she added.

The physical size of Yale-New Haven is also a major issue, Schwartz said. The emergency department, which was built around 20 years ago, cannot accommodate the 200 patients that come in daily, he added.

Still, Schwartz said, the average wait time at Yale-New Haven — which varies by day and according to how urgently patients need to be seen — is around one hour, which is shorter than the wait time at a typical urban hospital.

Schwartz added that there are plans to double the capacity of the Yale-New Haven emergency department.

The data for the report came from numbers published in 2006 by the Center for Disease Control.

Comments

  • GRD ’13

    Yeah…my friend waited 6 hours to be seen about a brain injury. Wait time averages an hour only in the fantasy land the desires of administrators inhabit. That system is a shambles.

  • jhc

    I wonder if the injuries of people correlate somehow with bad water or the positioning of stars ?
    I went to the emergency room at Yale New Haven Hospital with the flu about 4 years ago and the total wait time was about one hour ( that’s seeing billing the nurse etc.) It was at 8am .
    My only other visit to the emergency room was at St. Rae’s for a shoulder injury which i was seen even quicker. Those are my only two visits in the past ten years though. I always had an usual horoscope

  • jhc

    Hospitality officer , Nurse, the billing inquiry desk,flush the toilet, etc
    …”i always had an unusual horoscope”

    sorry for the typos

  • sobhraj

    oh my god, went to the yale hosp last night and waited for 4 hours . came hm at 2 in the morning that was after just walking out after realizing i was going to get a anxiety attack soon. i think the person is going to die in the emergency room and then get out. never ever bother going there unless you are really desperate.