Emergency-room wait tries patients' patience

With more visits and fewer places to go, it takes longer and longer to see a doctor

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New federal statistics confirm what many patients in hospital emergency departments already knew: Wait times to see a doctor are getting longer.

Nationwide, the average wait grew to about 56 minutes in 2006, up from 38 minutes in 1997, according to a report released yesterday by the Centers for Disease Control and Prevention.

About half the people had wait times of about a half-hour or less, but the average was higher because some patients had much longer waits, said Dr. Stephen Pitts, lead author of the federal report.

He attributed the trend to several factors, including more emergency room visits even as the number of emergency departments has declined. Some of the increased visits reflect growth in the U.S. population.

Local hospital officials also have reported struggles with wait times.

At Heritage Valley Sewickley, average waits dropped from about 41 minutes several years ago to 30 minutes two years ago, then edged up to 36 minutes last year, said Dr. Tom Pangburn, the hospital's medical director.

"We're seeing more people -- not only sicker people, but more of them," he said.

At Jefferson Regional Medical Center, most patients wait about a half-hour to be seen in the emergency department, though some waits can be an hour or more, said Karen Kunak, director of emergency services.

Average waits at Allegheny General Hospital are about one hour, similar to those at other level one trauma centers, said spokesman Dan Laurent, noting that recent efforts have been made to improve patient flow.

Other hospitals in the West Penn Allegheny Health System have average waits of about a half hour for most patients, he said.

About 118 million visits were made to the nation's emergency rooms in 2006, up from nearly 93 million in 1997, according to the American Hospital Association. But in the same period, the number of emergency departments dropped, from more than 4,800 in 1997 to fewer than 4,600 two years ago.

A decline in the number of inpatient beds also has contributed to longer waits, said Dr. Pitts, a fellow at the CDC's National Center for Health Statistics. Some patients are spending more time in the emergency department, and occupying staff time, as they wait for an inpatient bed to become available.

He also noted that half of hospital admissions in 2006 came through emergency departments, an increase over previous years.

In Pennsylvania, the number of emergency departments also has dropped as visits have increased, according to the Hospital & Healthsystem Association of Pennsylvania.

People without health insurance turn to the emergency department for health care and often wait until they are very sick to seek treatment, the group said.

Other trends that can strain the system, according to the association, include patients with chronic disease, seriously mentally ill patients in crisis, and other patients who turn to the emergency department rather than a doctor's office for treatment.

The association said hospitals are responding with several steps, including expansions, new technology to improve the flow of patients through the system and "fast track" systems that divert patients with less serious needs to health professionals who can provide prompt care.

At Heritage Valley Sewickley, Dr. Pangburn said, efforts to move patients through the system include improved registration, directing people with less severe needs to nurse practitioners or physician assistants, adding emergency department beds and finding ways to better identify other open beds elsewhere in the hospital.

And among other measures at Jefferson, emergency department officials can call a "code orange" or "code purple" to alert other personnel that they need to make special efforts to complete lab work, free up beds or otherwise speed up the process, Ms. Kunak said.

Mr. Laurent noted that, in the West Penn Allegheny Health System, new emergency departments with expanded patient care capacity have opened in the past two years at Canonsburg General Hospital and West Penn Hospital's Forbes Regional Campus, and a new emergency department is being built at Alle-Kiski Medical Center.

Average wait times were not immediately available from the University of Pittsburgh Medical Center, but spokeswoman Wendy Zellner said processes are in place to improve patient flow in many of the system's emergency departments.

Barbara Manion, hospital coordinator at The Western Pennsylvania Hospital in Bloomfield, said waiting times in emergency rooms are unpredictable. She said hospitals do their best to have enough staff on duty.

The busier times, she said, tend to be late evening hours. At 7:40 p.m. last night, the hospital's emergency room off South Millvale Avenue was empty. Two people who came in with minor injuries during the next 20 minutes were seen immediately by the triage nurse and two receptionists.

Staff writer Dan Majors and The Associated Press contributed. Joe Fahy can be reached at jfahy@post-gazette.com or 412-263-1722.


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