Had the usual 1900 influx of people and 45 waiting. We have 25 bed, had pt's in the hall ways, still had pt's on cots with various wounds etc. This is the typical night. We were on city wide diversion. We were getting the usual knife in the back stares from pt's waiting. (most of which didn't need to be there in the first place). There was a guy with a 7 or 8 year old with abd. pain, n/v no fever , had been reassesed a couple of times so on and so on. The boy was a priority even though we suspected it was viral as opposed to appy or worse. The man was irate. He yelled at us told us this would never happen in Chicago. Maybe I'm wrong, but , I find it really hard to belive that Chicago has low wait time. I get sooooo, tiered of being treated like Sh#$. I understand pain , fever and general sickness.....I truley do. I feel so bad for many pt's that have to wait. I wish there were some way to take care of people better. Of course, with some people it wouldn't matter, they enjoy pushing their wait around. So: to get back to my question, how long is your average wait?
I think what every one is forgetting that we are always trying to compare appples and oranges in healthcare...
The big thing in the media in Canada is wait times... wait times for surgery, ait times for cancer treatment,wait times for emergency care etc.
The media never distinguishes between wait times for AAA repairs (I've never seen a team move so fast), trauma interventions, loss of limb etc., or non urgent care (hip replacements, knee replacements), sore toe.
What exactly does "Wait time" mean (at least in an ER context)?
... Does it mean the amount of time to be greeted coming in the door (time X) ?
... Does it mean time "x" to registration or triage ?
... Does it mean time "x" to be brought in to be assessed by an RN (often with stretcher, IV, initial testing blood work)?
... Does it mean time "x" to MD assessment (or resident coming to see then discussing case with the ER doc), and orders received for diagnostics.
... then of course their is the wait time from time "x" to diagnostic imaging, blood tests, ultrasound and CT scan for that vague abdominal pain in your 94 year old grandma.
Oh, and don't forget the wait time from time "x" to having the general surgeon (or surgical resident) getting away from the OR (love those knee replacements) to come talk to you and making plans to observe overnight in the ER.
I get the feeling that most of the time wait times refer to the time from time "x" to the doctor just giving the paitient their bloody percocets for their sore toes, so that they can swear at me and get their taxi slip to go to their cousins house.
Maybe wait times refer to from time "x" to beign admitted and having all of your lifes problems solved in the ER (sorry if I am getting more sarcastic as we go along).
So what is it... what is your definition of wait time ? we need to sort this out before having a meaningful discussion about how to resolve wait times.
Believe me....the wait can be much longer. I am an RN at University Hospital in Louisville, KY. We are one of the largest trauma institutes in the country (the only level 1 trauma center in the area). We can hold up to 86 patients in the trauma center alone. Summer and weekends are obviously the busiest times of the year for us. We are usually on total bed diversion and sending patients to other hospitals is not an option for several reasons. 1) We are the only hospital with the resources to handle the patient acuity or 2) The patient was sent to us from another hospital because of their acuity. Patients just don't realize that there are far few healthcare professionals then there are patients. It would be nice to have a 1:1 nurse to patient ratio, but it's not possible. As for the average wait time?? I don't really know because it varies day to day, even hour to hour. We are constantly hounded to discharge patients that really need to stay where they are, just so we can make room for more patients. Another thing that patients don't realize......IT'S NOT OUR FAULT! Hang in there :)
We often see a broad spectrum of philosphies concerning patient flow in ER's. Ranging from :
let them rot in the waiting room for their sore toe, I need to keep beds open for more serious patients.
to
Gotta get those patients out of the waiting room right now to back up stretchers in the hallway so that they can be seen and wait (staring at my back) for the answer to all of lifes problems.
There are negatives to both extremes of the scale, I think the happy medium is best, the challenge is dealing with coworkers who prescribed to different philosophies.
Of course having the non urgent abd pain who codes in the waiting room really throws aeverything out the window.
In my ER we tend to move peole through very quickly (perhaps too quickly in my opinion). Our ambulatory care patients will be in and seen by a physician long before an abdominal pain patient. (major pet peeve). Patient flow issues are being assessed and big changes are coming down the pipe both for Nurses and MDs.
I was looking at the links posted fro the "30 minute Guarantees" and can't figure it out. It doesn't actually say anything useful.
I think that the only "30 minute guarantee" in the ER we should be worrying about is perhaps the door to needle time for thrombolytics, even though that would be one slow ass ER. Eerything else is just minor details.
Very small ER, the wait is usually less than 30 minutes. We have a large amount of people who moved here from Chicago and they always comment how they had to wait forever in Chicago to be seen.
Specializes in icu, er, transplant, case management, ps.
Let's see, these have been my experiences around the country.
]Port Charlotte, Florida 5 minutes, I only went to the ER when I was having an asthma attack. 1990-1994
Sarasota, Florida 5 to ten minutes, Same reasons for visits 1994-1998.
Mercy Hospital, San Diego 1996 cellulites of the face 20 minutes
Port Charlotte, Florida 1998 to 2000 less then five minutes asthma
Roosevelt Hospital, NYC 1999 less then a minute, despite being a walk in. Asthma
Chattanooga, Erl anger 2000 to 2003 Asthma five to 15 minutes
Flagstaff, less then 5 minutes asthma May 2001
El Centro, 1.2 K less then five minutes, May, 2001
Albany Medical Center less then 5 minutes up to 45 minutes. Broken leg, asthma, pneumonia, smoke inhalation
Port Charlotte Florida 2003 to present 5 to 40 minutes, asthma now must be seen by triage nurse unless brought in by rescue squad
I cannot complain. But then I rarely go to the ER unless I can't break an attack or I am bleeding from some area on my body, or I have had a broken bone. And yes, I do travel a lot around this country of ours. And have sampled some of the best ERs of our country.
i wonder what hospital in chicago he went to?? the county hospital in chicago can have a 12-16hour wait. even the private hospitals have up to a 6 hour wait. it doesn't bother me any more when patients complain about wait time. i understand and i empathize, but i can't change it so the less i think about it the less stressed i am.
s
Yes I agree, I have developed a blank, fake smile that say's , thanks for letting me know you've been here 3 hours for your hang nail. Have a nice day .....have a seat. When people tell me their leaving, I just say OK....under my breath I think don't let the door hit you where the good lord split ya. Or my favorite line is, "This is not Bob Evans, it's not first come first serve. " I wounder if I could get introuble saying that (you know pres gainy's and all). But, like one of the Dr's said , nothing about that statement is untrue. We are not Bob Evans, and it's not firsrt come first serve.
Specializes in icu, er, transplant, case management, ps.
I count my wait time from the minute I enter thru the door until the time I am seen by an ER physician/nurse and treatment is begun. And about the person with the big toe that is hurting. How do you know he isn't a diabetic? How do you know that the pain in his big toe isn't a symptom of an occlude artery or vein and the patient is slowly losing his toe or his foot or his leg? Something as small as a pain in the toe can be a symptom of a much larger problem. How would one like to be responsible for a patient losing his foot because someone judge the patient and felt his problem was a very minor one? I wouldn't.
tonight (which was eerily slow) it was approx. 30 to 45 min., but on busy nights it's 1-3 hours, and nights during peak season when we're slammed it can be anywhere from 4-7 hours. i really don't care if they give me the evil eye. the ones that need to be seen are brought back, and the other non-emergent pseudo-illnesses can wait til the cows come home. it's an er, not a clinic. we have signs posted everywhere that the sickest child is seen first, and if they don't like that, they can go to the county hospital where the wait is usually 10+ hours.
one_speed
32 Posts
Ah, the ever present argument about wait times...
I think what every one is forgetting that we are always trying to compare appples and oranges in healthcare...
The big thing in the media in Canada is wait times... wait times for surgery, ait times for cancer treatment,wait times for emergency care etc.
The media never distinguishes between wait times for AAA repairs (I've never seen a team move so fast), trauma interventions, loss of limb etc., or non urgent care (hip replacements, knee replacements), sore toe.
What exactly does "Wait time" mean (at least in an ER context)?
... Does it mean the amount of time to be greeted coming in the door (time X) ?
... Does it mean time "x" to registration or triage ?
... Does it mean time "x" to be brought in to be assessed by an RN (often with stretcher, IV, initial testing blood work)?
... Does it mean time "x" to MD assessment (or resident coming to see then discussing case with the ER doc), and orders received for diagnostics.
... then of course their is the wait time from time "x" to diagnostic imaging, blood tests, ultrasound and CT scan for that vague abdominal pain in your 94 year old grandma.
Oh, and don't forget the wait time from time "x" to having the general surgeon (or surgical resident) getting away from the OR (love those knee replacements) to come talk to you and making plans to observe overnight in the ER.
I get the feeling that most of the time wait times refer to the time from time "x" to the doctor just giving the paitient their bloody percocets for their sore toes, so that they can swear at me and get their taxi slip to go to their cousins house.
Maybe wait times refer to from time "x" to beign admitted and having all of your lifes problems solved in the ER (sorry if I am getting more sarcastic as we go along).
So what is it... what is your definition of wait time ? we need to sort this out before having a meaningful discussion about how to resolve wait times.
Regards
Ian (after 4 night shifts in the ER)