Why Are Emergency Rooms So Slow?

Few experiences feel more excruciating than awaiting treatment in an emergency room. A smaller number of emergency departments, coupled with more uninsured people requiring care, is the most common scenario blamed for the longer waits. Hospitals are trying various methods to tackle the issue.

Size

• Few authorities disagree that longer waits have become a serious problem. In November 2006, the Associated Press reported that the average wait has ballooned to 222 minutes nationwide.

Features

• Dealing with the uninsured poses major challenges for emergency rooms.

  Between 1993 and 2003, the number of emergency departments fell by 425, or about 12 percent, the Associated Press reported. However, the number of uninsured patients seeking emergency care also jumped by 26 percent, to 114 million, leaving hospitals caught in a classic squeeze.

Effects

• Failure to keep pace with patient needs also has consequences, a November 2007 Yale study found. Only 25 percent of the hospitals surveyed admitted that they admitted 90 percent of patients in four hours, or less. Yale-New Haven's emergency room was built 20 years ago, which cannot handle the 200 patients per day who enter its doors.

Considerations

• Juggling multiple patients' needs is difficult, especially when many subgroups can be identified within insured and uninsured patients. Older people represent the fastest-growing category of emergency room visitors, yet many hospitals have not developed contingency plans to address the situation, the "New York Times" reported in November 2008.

Prevention/Solution

• Hospitals are experimenting with different technology to cut waiting times.

  Offering restaurant-style pagers to patients is only one solution that hospitals are using to reduce waiting room times, the Associated Press reported. Other solutions include speeding up triage, the first basic step that determines the patient's care; providing test results on-site, or online; and, for patients who call early, giving them same-day examinations.

Benefits

• Increasingly, the hospitals are aiming their solutions at uninsured patients. This proved particularly true for New York's Montefiore Medical Center, which spent about $35 billion on a fast track program for uninsured patients not requiring hospital treatment, the Associated Press indicated. The program is credited with cutting arrival-to-discharge times from six hours, to just two.