Report: ER wait times rise; proper communication soothes dissatisfaction

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ER wait times in U.S. hospitals are the longest since 2002, reaching four hours and seven minutes in 2009, an increase of four minutes compared to 2008 and 31 minutes more than the nationwide average in 2002, according to a report from Press Ganey Associates.

In terms of wait time, Utah had the worst performance, with an average time of eight hours and 17 minutes—nearly an hour and a half longer than the state's average time spent last year.

Iowa had the shortest average time at just under three hours (2:55), followed by South Dakota (2:59), North Dakota (3:07), Nebraska (3:08) and Minnesota (3:11). Nevada made the biggest improvement in 2009, reducing average wait time by 66 minutes since 2008.

"Although the overall national average wait time increased slightly, what we found encouraging is that 32 states had either reduced wait times or held increases in wait times to five minutes or less over the previous year," said Deirdre Mylod, vice president, hospital services, Press Ganey.

A statement from the American College of Emergency Physicians (ACEP) said that the recession, high unemployment and insurance losses are increasing pressure on emergency departments and their patients.

"The report finds pockets of good news, such as shorter times overall in Nevada, but nobody can possibly call a national average of more than four hours in the emergency department something to cheer about," said Angela Gardner, MD president of the ACEP.

"Policymakers and the public also should have no illusions that the recently passed healthcare legislation is going to decrease ER use. Massachusetts, which enacted healthcare reform in 2006, has seen an increase in emergency department visits, with no decrease in patient acuity. It proves that healthcare coverage is no guarantee of healthcare access," Gardner said.

Patient satisfaction

According to the Press Ganey report, overall patient satisfaction with U.S. hospital ERs stayed about the same in 2009. However, patients who had long waits of three to four hours were just as satisfied as patients who spent less than one hour in the ER if they were kept informed about delays.

"Patients would, of course, prefer a more efficient process," said Mylod. "But good communication helps them understand the processes within the emergency department environment and shows them that staff has not forgotten them. Frequent, proactive communication improves both the quality of patient care and the manner in which patients perceive their care."

Another factor impacting patient satisfaction with ERs is the time of day patients arrive. According to the report, patients who arrive between 7 a.m. and 3 p.m. evaluate their care much more favorably than those who arrive after 3 p.m.

Patients who arrive on Monday and Tuesday rank lowest in terms of patient satisfaction, while Saturday and Sunday evaluations of care are the highest.