US Emergency Department Performance on Wait Time and Length of Visit

Abstract

Objective Prolonged emergency department (ED) wait time and length of visit reduce quality of care and increase adverse events. Previous studies have not examined hospital-level performance on ED wait time and visit length in the United States. The purpose of this study is to describe hospital-level performance on ED wait time and visit length. Methods We conducted a retrospective cross-sectional study of a stratified random sampling of 35,849 patient visits to 364 non-Federal U.S. hospital EDs in 2006, weighted to represent 119,191,528 visits to 4,654 EDs. Measures included EDs' median wait times and visit lengths, EDs' median proportion of patients seen by a physician within the time recommended at triage, and EDs' median proportion of patients dispositioned within 4 or 6 hours. Results In the median ED, 78.3% (interquartile range [IQR], 63.2%, 89.5%) of all patients, and 66.9% (IQR, 52.0%, 81.9%) of patients who were triaged to be seen within one hour were seen by a physician within the target triage time. A total of 30.5% of EDs achieved the triage target for more than 90% of their patients; 13.8% of EDs achieved the triage target for 90% or more of patients triaged to be seen within an hour. In the median ED, 76.3% (IQR 54.4%, 93.9%) of patients were admitted within 6 hours. A total of 47.7% of EDs admitted more than 90% of their patients within 6 hours, but only 24.5% of EDs admitted more than 90% of their patients within 4 hours. Conclusions A minority of hospitals consistently achieved recommended wait times for all ED patients, and fewer than half of hospitals consistently admitted their ED patients within 6 hours.