Most Large EDs Board Admitted Patients for More Than 2 Hours

WASHINGTON — Approximately 87% of large, high-volume emergency departments “board” admitted patients for more than 2 hours, based on the latest estimates from the National Hospital Ambulatory Medical Care Survey of 337 emergency departments.

Large emergency departments—defined as those that handle more than 50,000 visits per year—make up only 18% of all EDs in the United States, but they manage approximately 44% of all ED visits, Linda McCaig of the Centers for Disease Control and Prevention said at a workshop sponsored by the Institute of Medicine.

Ms. McCaig shared ED estimates for items that were added to the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS) hospital induction interview in the wake of the 2006 IOM report on emergency care in the United States.

The report raised concerns about overcrowding, fragmentation of care, lack of disaster preparedness, and the need for better emergency care for children.

The NHAMCS was designed to collect, analyze, and share information about the health care in emergency departments and outpatient medical departments. The data are collected from a national sample of hospitals across the United States, excluding federal, military, and Veterans Affairs facilities.

Data are taken from patient record forms, which are completed by hospital staff based on instructions from the CDC.

Overall, 63% of EDs board patients, including 83% of medium-sized EDs (20,000-50,000 visits per year) and 39% of small EDs (fewer than 20,000 visits per year).

Just over half (51%) of all EDs reported having a designated inpatient bed coordinator to help manage patient flow, including 71% of large EDs, 63% of medium EDs, and 34% of small EDs.

One-third of all EDs in the United States don't use any type of electronic medical records, including 18% of large EDs, 26% of medium EDs, and 54% of small EDs, Ms. McCaig said.

These NHAMCS data provide an example of how EDs are responding to the recommendations from the 2006 IOM report, which include creating a coordinated, regionalized system for emergency care and putting an end to the practice of boarding ED patients and diverting ambulances.

“This meeting and the two that will follow in the next few months are an opportunity, 3 years later, to revisit the committee's recommendations, to assess what progress we have made in achieving the committee's overall vision of a regionalized, coordinated, and accountable emergency care system,” said Dr. Arthur Kellermann, a professor and associate dean for health policy at Emory University in Atlanta, who served as the workshop chair.

WASHINGTON — Approximately 87% of large, high-volume emergency departments “board” admitted patients for more than 2 hours, based on the latest estimates from the National Hospital Ambulatory Medical Care Survey of 337 emergency departments.

Large emergency departments—defined as those that handle more than 50,000 visits per year—make up only 18% of all EDs in the United States, but they manage approximately 44% of all ED visits, Linda McCaig of the Centers for Disease Control and Prevention said at a workshop sponsored by the Institute of Medicine.

Ms. McCaig shared ED estimates for items that were added to the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS) hospital induction interview in the wake of the 2006 IOM report on emergency care in the United States.

The report raised concerns about overcrowding, fragmentation of care, lack of disaster preparedness, and the need for better emergency care for children.

The NHAMCS was designed to collect, analyze, and share information about the health care in emergency departments and outpatient medical departments. The data are collected from a national sample of hospitals across the United States, excluding federal, military, and Veterans Affairs facilities.

Data are taken from patient record forms, which are completed by hospital staff based on instructions from the CDC.

Overall, 63% of EDs board patients, including 83% of medium-sized EDs (20,000-50,000 visits per year) and 39% of small EDs (fewer than 20,000 visits per year).

Just over half (51%) of all EDs reported having a designated inpatient bed coordinator to help manage patient flow, including 71% of large EDs, 63% of medium EDs, and 34% of small EDs.

One-third of all EDs in the United States don't use any type of electronic medical records, including 18% of large EDs, 26% of medium EDs, and 54% of small EDs, Ms. McCaig said.

These NHAMCS data provide an example of how EDs are responding to the recommendations from the 2006 IOM report, which include creating a coordinated, regionalized system for emergency care and putting an end to the practice of boarding ED patients and diverting ambulances.

“This meeting and the two that will follow in the next few months are an opportunity, 3 years later, to revisit the committee's recommendations, to assess what progress we have made in achieving the committee's overall vision of a regionalized, coordinated, and accountable emergency care system,” said Dr. Arthur Kellermann, a professor and associate dean for health policy at Emory University in Atlanta, who served as the workshop chair.

WASHINGTON — Approximately 87% of large, high-volume emergency departments “board” admitted patients for more than 2 hours, based on the latest estimates from the National Hospital Ambulatory Medical Care Survey of 337 emergency departments.

Large emergency departments—defined as those that handle more than 50,000 visits per year—make up only 18% of all EDs in the United States, but they manage approximately 44% of all ED visits, Linda McCaig of the Centers for Disease Control and Prevention said at a workshop sponsored by the Institute of Medicine.

Ms. McCaig shared ED estimates for items that were added to the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS) hospital induction interview in the wake of the 2006 IOM report on emergency care in the United States.

The report raised concerns about overcrowding, fragmentation of care, lack of disaster preparedness, and the need for better emergency care for children.

The NHAMCS was designed to collect, analyze, and share information about the health care in emergency departments and outpatient medical departments. The data are collected from a national sample of hospitals across the United States, excluding federal, military, and Veterans Affairs facilities.

Data are taken from patient record forms, which are completed by hospital staff based on instructions from the CDC.

Overall, 63% of EDs board patients, including 83% of medium-sized EDs (20,000-50,000 visits per year) and 39% of small EDs (fewer than 20,000 visits per year).

Just over half (51%) of all EDs reported having a designated inpatient bed coordinator to help manage patient flow, including 71% of large EDs, 63% of medium EDs, and 34% of small EDs.

One-third of all EDs in the United States don't use any type of electronic medical records, including 18% of large EDs, 26% of medium EDs, and 54% of small EDs, Ms. McCaig said.

These NHAMCS data provide an example of how EDs are responding to the recommendations from the 2006 IOM report, which include creating a coordinated, regionalized system for emergency care and putting an end to the practice of boarding ED patients and diverting ambulances.

“This meeting and the two that will follow in the next few months are an opportunity, 3 years later, to revisit the committee's recommendations, to assess what progress we have made in achieving the committee's overall vision of a regionalized, coordinated, and accountable emergency care system,” said Dr. Arthur Kellermann, a professor and associate dean for health policy at Emory University in Atlanta, who served as the workshop chair.