• The American College of Emergency Physicians recently released the 2014 National Report Card on America’s Emergency Care Environment.
  • This comprehensive, state-by-state report card evaluates the support for emergency care in the United States.
• One area to highlight from the Report Card is the issue of emergency department (ED) crowding.
  • Crowding primarily results from keeping admitted patients in the ED for hours while waiting for an inpatient bed. This happens not only in the U.S., but in many other countries as well.
• For the U.S. overall, the median time from ED arrival to ED departure for admitted patients was 272 minutes (approximately 4.5 hours).
  • However, median times for individual states ranged from the best time of 176 minutes (approximately 3 hours) to 452 minutes (approximately 7.5 hours).

Bottom line

ED crowding remains a critical problem in the US and globally.  It is frequently driven by the “boarding” of admitted patients.  Improved patient flow is needed to be able to take care of patients presenting with acute care needs.

University of Maryland Section of Global Emergency Health

Author: Jon Mark Hirshon, MD, MPH, PhD

References

www.emreportcard.org; America's Emergency Care Environment, A State-by-State Report Card: 2014 Edition. Report Card Task Force Members; ACEP Staff. Ann Emerg Med. 2014. Feb;63(2):100-243