Hospitals Aim To Reduce Emergency Department Wait Times as Part of Effort To Address Medical Errors, Improve Patient Care
The AP/Houston Chronicle on Sunday examined strategies that some hospitals and physician offices have begun to use to reduce wait times for patients. According to the AP/Chronicle, health care providers for years have faced "overcrowding, overbooking and patients' complaints" about long wait times for care and laboratory test results. In response, several hospitals have established "fast-track" programs to expedite care for patients who visit emergency departments for nonemergencies. For example, Montefiore Medical Center in New York City over the past five years has hired 50 additional ED physicians, established a separate area for fast-track care and implemented an electronic patient registration system. The changes have allowed Montefiore to reduce average arrival-to-discharge time for patients who visit EDs for nonemergencies from about six hours to two hours. In addition, the changes have allowed Montefiore to reduce the walkout rate -- the percentage of ED patients who leave because they cannot wait any longer -- from about 5% to 1.5%, according to Peter Semczuk, vice president of clinical services at the hospital. According to the AP/Chronicle, the reduction in the walkout rate at Montefiore is "significant because walkout patients often get sicker and show up later in worse shape." Some hospitals also have begun to distribute pagers to ED patients to allow them to leave the waiting area. Other hospitals have added nurses or have begun to include preliminary examinations of ED patients in the triage process to allow physicians to order X-rays and other tests earlier.
Physician Offices, Lab Test Results
Physicians also have sought to reduce wait times in their practices. The American College of Physicians earlier this year recommended that health insurers begin to reimburse physicians for telephone and e-mail consultations. ACP also supports "open-access" scheduling, in which physicians reserve as much as 70% of their daily schedules for patients who call early for same-day appointments. In addition, some physician offices and hospitals have begun to use private online accounts that allow patients to receive lab test results earlier (Tanner, AP/Houston Chronicle, 11/5).