ED Wait Times

[EMS Solutions]

What is the longest you have waited for a bed at the ED? Going to discuss this on the podcast this week and wondering what some of the longest and shortest times are.

[chbare]

We all know and have probably all experienced long wait times. However, I wonder if a discussion about plausible solutions is warranted? The problem is not projected to improve and may significantly deteriorate as the nations transitions to "Affordable Care."

[Arctickat]

We only usually wait a couple of hours, but there have been times that we spent 4 hours at the hospital with our patient and did the entire consult in a hallway. If the patient needed x-rays or CT we've take them there, then back to the hallway. Once the consult was complete, back to our ambulance and return home.

[spenac]

They always find a place for patients here so never have had issue with waiting. Now when the hospital is swamped we have stayed while they get additional staff called in and we continue to work under our full protocols.

[WolfmanHarris]

It's been getting way better. At it's worst crews have spent the whole shift taking over the previous crew's patient and then handing off to the next crew at shift change. Now, leaving aside the last two awful weeks we usually don't see more than 30-45 minute offload delay. More at some hospitals way less at others.

A few solutions have been implemented with some success.

1) Dedicated OLD RN. This nurse takes moderate and low acuity but requires a bed patients. They are assigned to these hall beds and aren't to be reassigned to other areas since their position is funded by the service and the province just for this.

2) improved patient flow and resource utilization by the hospital. The hospitals have gotten away from giving everyone a bed. Larger and larger section of emerg are putting patients in chairs and only moving them into exam rooms as needed. This keeps beds open for those that really need them. They have also started moving patients into arm chairs with telemetry where appropriate. (Resolved chest pain for example)

3) Show me the money. The Regional council has long given the hospitals money towards capital expenses each year. Starting two years ago they began clawing back that money proportional to amount of time spent over 30 minutes that crews wait on average. The loss of hundreds of thousands of dollars got some very good results as all levels of staff started taking the problem more seriously. Prior to this it was treated as primarily an EMS problem not a hospital one.

[cprted]

The large regional hospital in the next city over from me has some horrific wait times. There have been more than a few patients that have been held in the ambulance off-load delay area for 10-12 hours. Not uncommon at all for people with non-urgent problems, but just sick enough that can't go into the minor treatment area, to wait 3-5 hours before getting a bed being seen.

[Just Plain Ruff]

I'm sorry but wait times of 10-12 hours for a bed is just unacceptable. I don't know the solution but this is just terrible patient care on the part of the hospital. If the wait times are going to be that long then the hospital needs to be on divert. But I don't have the answers so I'm not much help. Just a rant on my part.

[island emt]

In our area we have two tertiary hospitals, longest at either was about 45 minutes when we had someone who couldn't be put in a chair to wait. More critical pt's always get seen within 5 minutes for eval and transfer to a bed. Might be a hall bed brought in from day surgery , but they are still evaluated and placed in the waiting for follow up care line. Some might go to X-ray while waiting.

If we go to the big city trauma center/ Cardiac center/ stroke center, an hour 1/2 south low acuity go through triage and high acuity right to trauma room or cardiac ICU. We have a stemi system protocol in place that lets us bypass ER and go straight to Cath lab floor for transfer.

Edited January 5, 2013 by island emt

[MikeEMT]

5 minutes is my longest wait time. We roll in and usually are immediately seen. At most of our hospitals we have to give a HEAR so they know we are coming. At Harborview no HEAR is required but they Triage the patient as soon as we roll in. Usually the delay comes from waiting for someone to clear the vitals tree so I can get a set of vitals.

I had one 20 minute wait once but that was because the room they had for us wasn't clean.

[medicgirl05]

We don't have any lengthy wait times at any of our ER's. I guess we are lucky.

@Mike-Why do you get a set of vitals at the ER and why are you waiting for a vital tree? I have never gotten a set of vitals in the ER for someone I'm bringing in...Just curious.