Patients Spent Average of Four Hours, Seven Minutes in U.S. Emergency Departments in 2009, According to New Report From Press Ganey

Patients at U.S. hospitals are experiencing the longest wait times in emergency departments since reports were first made available in 2002, according to Press Ganey Associates, Inc., the health care industry's leading provider of quality improvement solutions.

From the moment patients walk into a hospital emergency room until the time they are discharged from the emergency department, the average time spent was 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.

The data, included in Press Ganey's 2010 Emergency Department Pulse Report: Patient Perspectives on American Health Care, is based on evaluations of more than 1.5 million patients treated at 1,893 hospitals in 2009.

In terms of wait time, Utah had the worst performance, with a staggering average emergency department time spent 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 spent at just under three hours (2:55), followed by South Dakota (2:59), North Dakota (3:07), Nebraska (3:08) and Minnesota (3:11). The full list of state by state average wait times is available at www.ImproveMyER.com.

Despite longer wait times, patient satisfaction with U.S. hospital emergency departments stayed about the same in 2009, following a five-year upward trend. More than half the states were able to improve wait times or keep increases to a minimum.

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. "Some states have done really well in keeping emergency department times in check, despite growing challenges of higher patient volumes and understaffing. But there's still a long way to go to make visits to the emergency department much more efficient for patients."

Communication is Key

The Press Ganey report found that communication is imperative in providing patients with satisfactory emergency department experiences. Patients are willing to wait for care as long as they are kept informed about wait times. Patients who waited more than four hours, but received "good" or "very good" information about delays were just as satisfied as patients who spent less than one hour in the emergency department.

In fact, patient evaluation of communication about delays is identified as a key driver nationally of satisfaction.

"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."

Many hospitals are instituting procedures such as whiteboards in exam rooms to keep patients informed about treatments or delays. Also, welcome letters or pamphlets provided by the hospital help patients understand the process of triage, treatment, etc.

Press Ganey has developed a sample list of what patients can expect in emergency departments at www.ImproveMyER.com.

Patient Flow

Improving patient flow is another way to keep patients moving efficiently through the system. A long wait time might not be indicative of the emergency department's performance. Instead, it could be a symptom of a larger hospital-wide issue that keeps the patients in the emergency department when inpatient beds or testing equipment is not readily available.

Arrival Times

Another factor impacting patient satisfaction with emergency departments 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 in the emergency department on Monday and Tuesday rank lowest in terms of patient satisfaction, while Saturday and Sunday evaluations of care are the highest.

Top 10 Metro Areas for Highest Emergency Department Satisfaction

After reviewing more than 1.5 million patient evaluations, Press Ganey ranked the following metro areas as the top 10 in terms of patient satisfaction for emergency department care:

1. Madison, Wis.

2. Grand Rapids, Mich.

3. Hartford, Conn.

- Indianapolis, Ind.

- New Orleans, La.

6. Miami-Ft. Lauderdale, Fla.

- Milwaukee, Wis.

8. Toledo, Ohio

9. Allentown-Bethlehem, Pa.

10. Albany, N.Y.

This is the third straight year that the Miami-Ft. Lauderdale metro area appeared on the list.

The findings and observations of the Emergency Department Pulse Report highlight progress being made in hospitals, emphasize areas for improvement, and explore the path to improving the quality of health care in the United States. Press Ganey works with emergency department administrators to assist them with best practices such as implementation of "fast tracks" or hiring dedicated staff charged with improving communication about delays in the emergency department. Other strategies for improving emergency department patient satisfaction include:

Analyze and interpret patients' perception of care
Identify priorities for improvement specific to each institution
Recommend specific best practices
Facilitate change management within the hospital including accountability and reward and recognition
Improve clinical and operational processes to improve flow and reduce waiting time

"Improving patient satisfaction is not just about making patients happy; it is about improving the patient experience for the overall good of healthcare," said Rick Siegrist, CEO of Press Ganey. "Satisfied patients are more likely to disclose information and follow treatment plans. They also are more likely to seek care when they need it, avoiding larger health issues in the future. The information from this report helps us work with hospital administrators, doctors and nurses to ensure that patient voices are heard and the right improvements are made to provide the proper emergency care everyone deserves."

Press Ganey Associates, Inc.

For 25 years, Press Ganey has been committed to providing insight that allows health care organizations to improve the quality of care they provide while improving their bottom-line results. The company offers the largest comparative customer feedback databases, actionable data, solution resources and unparalleled consulting and customer service. Press Ganey currently partners with more than 10,000 health care facilities — including over 40% of U.S. hospitals — to measure and improve the quality of their care. For more information visit www.pressganey.com.