If you go to the emergency room at Novato Community Hospital, how long will it take before you are evaluated?
The federal government says 19 minutes on average.
That’s better than the wait of 34 minutes at Marin General Hospital, according to a new database causing some hospital officials nationwide to cringe. It takes the ERs of Novato Community and Marin General an average of 113 and 134 minutes, respectively, from the time that a patient arrives in the ER to the time they are sent home. In that category, both local hospitals bested the average across California (173 minutes) and across the United States (140 minutes). Data for Kaiser Permanente in San Rafael was unavailable for many of the categories measured, including emergency room performance.
Key measures of ER efficiency have been posted from hospitals taking part across the country, according to a report by former San Diego Union-Tribune writer Cheryl Clark, now senior quality editor for HealthLeaders Media.
“With precious little fanfare, Uncle Sam last month rolled out a big, fat database with seven measures comparing a service that many people—healthcare providers and patients alike—consider the most critical any hospital can provide,” Clark wrote last week.
Data collected in 2011 and early 2012 also tracked how long it took for an ER patient to be seen by a healthcare professional and how long the wait was to get a bed if they needed admission. Other data showed how long patients spent in the ER before being sent home and whether they received a brain scan if they might have suffered a stroke.
Clark interviewed Dr. Jesse Pines, an emergency room doctor and researcher who directs the center for healthcare quality at George Washington University.
“The theory is that when hospitals report this information, it makes them focus on it, and improve throughout their [Emergency Department],” Pines was quoted as saying.
“But it’s very hard to do. Certain performance measures are easier to fix—simple process measures like giving patients an aspirin—than improving ED throughput, which involves development of interdisciplinary teams.”
Pines told Clark the public attention pushes hospital administrators to focus on the emergency room as well as other metrics.
In a column, Clark said she thought the Centers for Medicare & Medicaid Services would “make a bigger fuss about such a major release.” She added:
Certainly with so much concern about ED overcrowding, and the number of patients being boarded in hospital hallways and even closets, coughing on each other and getting sicker as they wait, a three-month picture of the state of an ED’s throughput speed should be a very big deal.
But after a few conversations with emergency care experts who know how to read between the lines of this 29,664-record database, I started to realize how raw and flawed this effort still is.
She said a “bizarre glitch” by the Georgia Hospital Association showed wait times for 170 Georgia emergency rooms as “hopelessly inflated.”
The database said the Marin General ER saw 17,592 patients in 2011, with 1 percent (about 176) leaving the ER before being seen. Novato Community's ER, which saw 15,971 patients in 2011, also had a 1 percent (160 people) leave-before-being-seen rate.
For those who showed up to the ER with broken bones, Marin General patients had to wait 58 minutes before receiving pain medication, while Novato Community patients waited 39 minutes, according to the database.
In any case, residents can compare the ER care at their Marin hospital of choice with any two other local hospitals in the national database.
First go to the Hospital Compare website. Then type in your ZIP code, city or local hospital. When a list of hospitals is displayed, put a checkmark next to two or three hospitals.
Scroll down to a yellow button labeled Compare Now, and click to display more details. Look for a tab called Timely and Effecive Care and click that.
Finally, scroll down to a section called Timely Emergency Department Care. A green button allows you to “View More Details,” displaying something like this page comparing Novato Community Hospital and Marin General Hospital.
Have you tried the Hospital Compare website? What did you discover? And what do you think of the performance of Marin's hospitals? Tell us in the comments.