His smashed finger wrapped in bandages, Len Balon walked into an emergency room and eyed the flat-screen monitor broadcasting live wait times for Scottsdale Healthcare’s area hospitals. Osborn Hospital, where he was standing: two hours and 55 minutes. Thompson Peak hospital, a short distance away: four minutes.
Balon sat down to read a long Civil War memoir he’d brought in preparation for a long delay. His dread of an emergency room wait was justified. A study released this month found that wait times nationwide had continued to climb over the last 10 years.
Then the woman next to him got up and left, lured by the brief waits elsewhere. A few minutes later, someone else walked out too. Before long, Balon, who at first had said he would stay put, abandoned his book and drove across town to Thompson Peak.
In part to ease the minds of those seeking emergency care -- or at least disclose how bad the wait will be -- a growing number of suburban emergency rooms around the country are advertising wait times.
Some post the times on their websites. Others tweet, send text messages or display the times on huge highway billboards. A few are testing a service by a start-up company, InQuickER, that allows patients to register online, pay a small fee and hold their place in line while they wait at home.
“Emergency rooms are so taxed in this day and age for all the reasons -- access to healthcare providers, available beds, nursing shortages and ever-increasing populations,” said Jeannette Skinner, chief operations officer at Methodist Stone Oak Hospital in San Antonio, where the hospital posts and tweets its emergency room wait times. “For us, the main driver was to give the community some control. . . . We want people to be able to see this and make their own decisions.”
Patients are beginning to get this kind of information just as a study in the Nov. 9 issue of Archives of Internal Medicine shows that median wait times increased from 22 minutes in 1997 to 33 minutes in 2006. Wait times increased at a faster pace for the most critical patients. The study found that fewer than 57% of those who should have been seen by a doctor within 14 minutes because of the seriousness of their ailments had actually been cared for within the time recommended.
It may seem like a practical public service, but the posting of wait times -- a practice Southern California hospital officials say they have not seen here yet -- is not without its critics. Dr. David C. Seaberg, an American College of Emergency Physicians board member and dean of the University of Tennessee College of Medicine in Chattanooga, said he worries that it may be sending the wrong message to patients.
“Frankly, my opinion is that it’s a very bad idea to put waiting times up on a billboard,” Seaberg said. “When you get seen is a very complex process. . . . To put out a number can be misleading.”
Any hospital’s emergency room can change at a moment’s notice if there’s a serious crash or other multiple-injury event. At busy urban emergency rooms, patients may have to wait for hours, but doctors may get to patients within minutes at other facilities.
Some conditions should move people to the front of the line, no matter what, Seaberg said, but posting wait times might cause people with chest pains, for example, to drive farther when any emergency room would make them a priority.
“That’s a real problem,” Seaberg said. “If you’re really acutely ill, we’ll see you right away. It doesn’t matter how busy we are.”
Advocates of the practice say seriously ill or injured patients should call 911 or go to the nearest emergency room. But for everyone else, knowing ahead of time that the wait will be long could make them think twice about whether emergency care is truly required.
At Scottsdale Healthcare’s hospitals, the overall length of stay for patients -- from walking in the door to discharge -- is less than three hours, a one-hour decrease from that of the previous year, said Nancy Hicks-Arsenault, emergency services systems director.
Administrators there are aided by the proximity of their facilities, two of which are located 16.5 miles apart, with the third splitting the distance. Prospective patients whose emergencies aren’t life-threatening can log on to the Internet from home and choose which emergency room to visit based on the wait time. Or, like Balon, they can arrive at one facility, check out the monitor and then head to another hospital. If they have registered and decide to move, all their intake information is transferred for them.
“It’s a nice tool if people can use it,” Balon said, after being stitched up at Scottsdale Healthcare Thompson Peak Hospital and given a tetanus shot.
David Fiore, 55, made a beeline to the big-screen monitor as soon as he set foot in the Thompson Peak emergency room. He and his wife, Sharon, had first headed to Shea Hospital, the nearest to their home, worried that she may have broken a rib in a fall.
“We walked in, and they immediately said there’s a 125-minute wait but that if we came up here there’s a four-minute wait,” he said. “We were very thankful. It was worth the drive to come up here and not wait.”
At Stone Oak in San Antonio, Skinner said the staff so closely monitors wait times that personnel try hard to resolve delays when the number ticks up.
“It bugs them,” she said. “They don’t like seeing that number get higher and higher . . . so they start to self-assess very quickly.”
Speedy service in the emergency room -- which is often the first impression someone gets of a hospital -- can pay off later for hospitals in today’s competitive healthcare market, said Rick Wade, the American Hospital Assn.'s senior vice president of communication.
“Emergency rooms are never going to be big money makers, but if you have the experience be one that’s not the classic overcrowded ER . . . then the next time they need service, they might think of that place,” Wade said.
Some hospitals are going a step further and contracting with an outside company to help ease the flow of patients. InQuickEr allows people to register at a hospital emergency room on the Internet and hold their place in line.
It projects the time that the patient should arrive at the hospital and guarantees that the person will see a doctor within 15 minutes of that time or the visit is free.
The service, which costs $2.99 to $24.99, depending on the market, is currently available only at three hospitals in Georgia, Alabama and Florida. But founder Tyler Kiley said that by next year, the goal is to be in 30 emergency departments.
“At this point, I think it’s all about efficiency,” Kiley said. “There are so many ways that technology -- even relatively simple technology -- can be applied to basic customer service issues in healthcare.”
When Donzetta Miller used the service earlier this month, she said it was a “big difference” over her last emergency room visit, when she waited for several hours, only to be transferred to another hospital because no beds were available.
A neighbor touted the service, and when she received an InQuickER magnet in the mail, she stuck it to her fridge.
The next time her cellulitis flared up, with her fever hitting 102 degrees, Miller hopped online to InQuicker.com, paid the $24.99 fee and got her appointment time for two hours later.
She had time to pack a bag and call family. When she arrived at the hospital, a lab tech was waiting with an IV.
“It was well worth it, as far as I’m concerned,” Miller said. “I’m more comfortable laying at home being uncomfortable or sitting in my recliner than I would be sitting four, five, six hours in an emergency room.”