ER delays lead patients to forgo care, study says

Delays caused when emergency department patients must wait to be admitted to hospital beds have a direct influence on people who choose to leave the waiting room without seeing a doctor, new University of South Florida research shows.

Roughly 30 percent of emergency patients at urban critical-care hospitals like Tampa General Hospital are admitted for additional treatment. The longer those patients spend in transition, or "boarding," the more likely others in line behind them will give up and leave, said Jason Wilson, chief resident of the USF emergency medicine program.

"These boarding times are very dangerous for patients," said Wilson, co-author of the six-month analysis of Tampa General's 72-bed emergency department. Results of the study will be announced today at the American College of Emergency Physician annual meeting in Las Vegas.

In 2007, almost 117 million people went to American hospital emergency rooms for medical attention, according to the National Hospital Ambulatory Medical Care Survey. In 2008, the visits totaled more than 123 million.

That increased demand on emergency departments will be a problem if delays getting patients out of already busy emergency departments are not addressed, study co-author David Wein said.

"The idea was to show that it's a problem nationwide," said Wein, associate medical director for TeamHealth Southeast, sthe emergency physician group at Tampa General. "It's not a Tampa problem only."

ER wait times aren't a concern for physicians only. Hospital marketing departments in the Tampa Bay area and elsewhere are using a stopwatch approach to promote their facilities to patients who are well enough to choose where they want to go for care. Billboards and mobile phone applications now offer estimated wait times.

"Some patients I'm sure are deciding (on a hospital) based on wait times," Wein said. "But most don't. They arrive by ambulance."

The study's intent was to focus on patient safety and catching those who might walk out in frustration, he said.

The research results are being used by Tampa General committees focused on patient flow. Wilson said he has seen changes to the way patients are being treated and admitted.

"People in the entire hospital now know how important it is to get a patient safely to where they need to go," he said.