Press Releases & Statements

OVERCROWDED EMERGENCY DEPARTMENTS LEADING TO MORE DIVERSIONS, LONGER WAIT TIMES

New survey reveals cracks in health care's foundation

Contact:
Alicia Mitchell - (202) 626-2339
Amy Lee - (202) 626-2963

Washington D.C. (Monday, April 8th 2002)

A majority of the nation's emergency departments (EDs) are full, often operating "at" or "over" their capacity. One-third of hospitals are forced to go "on diversion" - rerouting ambulances to nearby EDs - according to a new survey from The Lewin Group, Inc. conducted for the American Hospital Association.

The survey found that more than six out of 10 hospitals felt that they are filled to capacity and cannot easily accommodate additional patients. ED capacity is a pervasive problem across the country. More than 90 percent of large hospitals with 300 beds or more report EDs "at" or "over" capacity. Nearly nine out of 10 trauma centers reported being overwhelmed.

"Overcrowding in the nation's emergency departments is a sign of a troubled system," said American Hospital Association Executive Vice President Rick Pollack. "At the same time when patients' needs are increasing, the nation's hospitals are facing a severe shortage of key hospital workers and soaring costs of the goods and services they need to do their job for communities."

A majority of urban and teaching hospitals experience some time when they must divert ambulances to other hospitals because they are full. ED diversion is a short-term, temporary approach used to assure that patients get the right care at the right time. More than half of urban hospitals reported some time on diversion. One in eight urban hospitals reported some time on diversion at 20 percent or more.

Lack of critical care beds was the number one reason cited for diverting ambulances. The workforce shortage is an important contributing factor. Hospitals reporting time on diversion at 20 percent or more had an average vacancy rate for registered nurses of 16 percent.

The survey also revealed that these constraints translated into longer waiting times for admission to a general acute or critical care bed. For example, the average time waiting for transfer from an ED to an acute or critical care bed was about 3.2 hours. In hospitals on diversion more than 20 percent of the time, the wait was 5.8 hours.

"Emergency diversions are a symptom of a series of compelling forces that are eroding the foundation of health care in this country," Pollack noted. "We need to shore up the system to better meet the needs of today's and tomorrow's patients."

Visits to the surveyed hospitals rose 5 percent from 2000 to 2001. That trend is expected to increase and pressure will likely mount on hospital EDs. More than 1,500 hospitals responded to the survey - representing 36 percent of hospitals with ED services.

About AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which includes more than 5,000 member hospitals, health systems and other health care organizations, and 38,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends.

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