Assessing wait time versus talk time in the emergency department

From MDLinx:

People expect to spend a lot of time in the waiting room when visiting a hospital’s emergency department, but the reality is that even after moving to a patient room the waiting continues. In a recent study, Northwestern Medicine investigators evaluated the amount of time patients talk with healthcare providers compared to how long they spend waiting in the emergency department. In a sample of 74 noncritical visits, the study found that 25 percent of a patient’s time in a “care space” outside the waiting room was direct interaction with a physician, nurse or technician. The findings were published in the Journal of Emergency Medicine. “On the flip side, this means that 75 percent of the time patients were in the care space they were waiting, again,” said Danielle McCarthy, ’06 MD, ’10 GME, assistant professor in Emergency Medicine. Dr. McCarthy explains that there are many reasons for these lulls. It might be deliberate, or unavoidable.

Nation’s emergency physicians announce second list of tests and procedures to question as part of Choosing Wisely campaign

From ACEP (press release):

Dedicated to reducing health care costs and improving patient care, the American College of Emergency Physicians (ACEP) announced a second list of five tests and procedures that should be discussed to help make wise decisions about the most appropriate care based on a patient’s individual situation. These recommendations are part of ACEP’s participation in the ABIM Foundation’s Choosing Wisely campaign and were announced at the organization’s annual meeting in Chicago.

  • Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma and a normal neurological evaluation.
  • Avoid CT pulmonary angiography in emergency department patients with a low–pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule–Out Criteria (PERC) or a negative D–dimer.
  • Avoid lumbar spine imaging in the emergency department for adults with atraumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition, such as vertebral infection or cancer with bony metastasis.
  • Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis.
  • Avoid ordering CT of the abdomen and pelvis in young otherwise health emergency department patients with known histories of ureterolithiasis presenting with symptoms consistent with uncomplicated kidney stones.