ER Waiting Times

Butterfly3001 · Mar 12, 2008

I am in the process of doing a research project for school talking about ER waiting times. I wanted to get some opionions on wait times from registration to triage, until getting into a treatment room and how long patients typically wait until sent to an inpatient bed. Also what kind of hospitals does everyone work in, how many beds does your ER have, and has your ER tried anything new recently to try and decrease your waiting times?
Thanks for your input!!

I am no an RN but I am a Unit Clerk in the ER at a teaching hospital in florida. I would say from my Unit Clerk opinion that it really depends on the patients situation. I'm sure like our ER alot of other ERs have ambulances and Helo paitents coming in. Even some patient family members who have fainted because of what they've seen! So it really depends on how dare I say BUSY it is in the ER. Another thing to consider is if it a Level one Trauma center or what, which the hospital is where I work. I've seen just this week Admitted Patients waiting on a bed in the hospital for over 24hrs, because the hospital itself is full and so are other area hospitals. So then you're gridlocked with a full waiting room of upset, disgruntled people.

TRAMA1RN · Mar 12, 2008

In the past year I have gone from an ER that has 50-55,000 visits annually not a level 1 trauma center to a Level 1 trauma center and now to a rural access ER. Wait times could be improved with better education of the public in the proper use of ER's as well as patients coming prepared with updated medication lists and allergies as welll as patients being truthful in their complaints. We have tried bringing every patient straigh to the back when beds are available to triaging every patient first to assign appropriate level, but I still think their needs to be a massive undertaking nationwide on educating the public on proper ER use.

evans_c1 · Mar 12, 2008

Like every other hospital in the world..it varies. our average (from triage to discharge) is like 4.5 hours. our hospital is smaller and our er has 23 beds right now. we are getting ready to double that number, too. I would say the average wait time from triage to bed placement in ed is maybe 45 minutes?? that is totally a guess.

ERRNTraveler, RN · Mar 12, 2008

I am currently at a large 65 bed ER in San Diego- our wait time just to get back to an ER bed can vary- if things are slow, it can be less than 30 minutes, if it's busy (and it usually is), patients can sit in the waiting room for 4-5 hours. We try to draw labs in triage from people who need them, so that when we do get them back to a bed, the results are already back.

LoveMyBugs, BSN, CNA, RN · Mar 12, 2008

Where I work it is not a trauma center. We have 23 beds, and a fast track. Last night it was about an hour wait to be seen by triage and then I have seen up to 5 hours for people waiting to get back to a bed. When it is that busy, and people are out in the waiting room, we will have labs drawn, xrays and last night we did CT's and ultrasounds before they made it back to a bed.

Our fast track area sees all of the dental pain, ear aches, med refills... so they are not taking up beds in the back, but when we are really busy the wait to see the fast track DR can get up to 2-3 hours.

Our goal is to be less than 20 mins to triage and 4 hours total.

mom2michael, MSN, RN, NP · Mar 12, 2008

I work in an 8 bed, rural hospital. We do limited trauma, surgery and ortho. We have 1 doctor, 2 RN's, 1 Medic, 1 tech, 1 admission clerk and a house supervisor that floats thru out and helps everyone out, though tends to focus his/her time in the ER espeically when we are busy.

We have a benchmark of 2 hours from time of door to the time of discharge. We reach that about 90% of the time for most patient. Obviously intense patients such as AMI's, CVA's, MVC's, ect...will take more time from start to finish for a complete work up and/or discharge or transfer. Also, in the evening there is usually no way to complete that 2 hour time frame because we just have too much volume in the evening time.

We attempt to triage everyone w/in 10 mins. That doesn't always happen when the 7:30 after dinner rush comes in to be seen.

If we have a room available in the ER, the patient comes straight back after a triage. If not, back to the waiting room. Wait times are really dependent upon what we have going on, but I would say 90% of the time the wait in the WR is less than 1 hour. We try to obtain items while the patient is in the WR such as UA's, X-rays, etc.....we don't normally draw labs because our Medical Director feels if they are that sick that they need labs, we need to find a bed even if that means putting them in our storage room or break room to be seen.

Once the patient is ready to be admitted, the process takes less than 30 mins from the time of the doctor to doctor to movement. Our inpatient floor is really good about helping us get the patient transfered ASAP. We probably admit 2-3 patients per shift, depending on a huge amount of factors.

When we transfer out we are the whim of the EMS or Flight Crew if we are flying but most of the time, we can get a transfer out w/in 10-15 mins. from the time of the doctor to doctor. We probably transfer out 3-4 patients a night, again, just depending.

We are supposed to be opening up to 12 beds soon and we are supposed to get a mid level (NP, PA) to help out during our busier time to see our more fast track patients which would allow our ER docs to focus on the more urgent patients. We as nurses try to focus on education with our patients at the time of discharge, espeically with parents. We focus on the importance of good PCP care, treating S/S at home, good nutrition, good hydration, washing hands, etc....But we dont' have a formal program in place.

For us, our Medical Director has been instrumental on education to EMS on what is appropriate to bring to our facility. Again, we don't have ortho probably 60% of the time, so bringing us an obvious fracture just so EMS can go back into service is really an injustice to our patient - they need a place that has ortho and that place is just an additional 30 miles down the road.

johnnrachel · Mar 12, 2008

In the past year I have gone from an ER that has 50-55,000 visits annually not a level 1 trauma center to a Level 1 trauma center and now to a rural access ER. Wait times could be improved with better education of the public in the proper use of ER's as well as patients coming prepared with updated medication lists and allergies as welll as patients being truthful in their complaints. We have tried bringing every patient straigh to the back when beds are available to triaging every patient first to assign appropriate level, but I still think their needs to be a massive undertaking nationwide on educating the public on proper ER use.

The news media needs to focus on telling people when they SHOULD run to the ER and when immediate care centers are more appropriate instead of focusing on scaring everyone on how BAD this flu season is or how DEADLY mrsa has become. I just saw on the news today the media made mention of two of our local hospitals (edwards and Good samaritian) that the ER actually had to TURN away ambulances. OH REALLY!!! Welcome to BYpass baby!!!!!! We have been on bypass a total of 122 hours this year 2008 alone and last entire year only 65 hours. Expand on this story by telling little Bobby's mother that he does not need to be rushed, triaged and seen by a doctor immediately for his sore finger from gym class today!!!!!!!!!!!!!!!!!!!!!!:smackingf:hpygrp:

Sorry off topic, just want to say honestly the average wait time to see an md has been between 5 and 10 hours respectively!!!!!!!!

pmose01 · Mar 13, 2008

Thank you to everyone that posted a reply to this thread so far. It sounds that your ERs are very similar to mine. I work in a Level 1 trauma and burn center in a poor inner city area. We see everyone from high class to the homeless and uninsured. We also get a large amount of the stupid complaints because people use us as a clinic b/c they do not have PCPs. Also, like you said, people need to be educated on what they can do at home to treat things like a cold or sore throat. They need to realize you dont have to run to the ER for everything. Also people bringing in their babies b/c they do not know basic parenting. Of course, how could they when these girls are now having children at the age of 14?

They are trying to improve our wait times, but it does not seem to be working. The average wait past 10am remains at 4 hours for main side or fast track. Our hospital NEVER goes on divert, we are not permitted, no matter how many patients are in the department or in the waiting room, they want everyone to be seen. For our hospital there seems to be so many other issues that are secondary to patients waiting including dirty beds on floors, delays in lab work or radiology,no ICU beds, no ICU nurses to take care of the patients.

I was researching online new things that ERs across the nation are doing to improve their wait times, it just seems like nothing is helping. I think that the key is going to be to educate the public, I just dont see that happening.

lpnstudentin2010, LPN · Mar 15, 2008

The only time I have gone to the ER recently I was taken back right away. I only saw 1 person in the waiting room and was there because I had vomited blood. I feel like I just got lucky however. Waits are probably usually longer.

Dave11, BSN, RN · Mar 16, 2008

I work in a small community hospital. Our ER has 17 medical, 6 psych and 7 fast track beds.

We currently triage first, then register the patients though that is supposed to change sometime in the near future. Probably when they can hire more registration personnel.

The wait from triage can vary drastically. In the morning, there may be no wait but by dinner time its 4 hours or vice versa.

The wait for inpatient beds has gotten better. Used to be 2-3 hours but recently its been closer to 1 hour. Except the ICU. there are never any beds available there because of staffing issues.

We do labs/xrays/CT/EKG from the waiting room on busy days also. The only other new thing implemented is increasing the number of physicians during typical peak hours.