Quality of Emergency Care Varies Widely Among Hospitals

120,000 additional lives could have been saved if all hospitals in the country operated their Emergency Departments as effectively as the top 5% in the country did. This is according to a new study released by Healthgrades in their first ever Emergency Medicine in American Hospitals Study. This report will now be published annually.

The most disturbing finding of the report is the wide variation that exists between hospitals, both individually and by state. More than 5 million Medicare records of patients admitted to hospitals through Emergency Departments at 4,907 hospitals between 2006 and 2008 were studied. The report focused on mortality rates of patients admitted with one of 11 conditions including bowel obstruction, COPD, diabetic acidosis, heart attack, stroke and pneumonia.

The top 5% of hospitals had a 39% lower risk adjusted mortality rate than the other hospitals. They also showed better improvement in their rates over the two year period than the other hospitals. This is very significant and should motivate all hospital Boards and top management to review their ED performance and focus on improvements.

There were also variations by state with over half of the top 5% coming from just five states: Ohio, Florida, California, Michigan and Illinois. Mississippi, Alabama and Hawaii had the worst overall risk adjusted mortality rates.

The report brought out another interesting fact that one half of all hospital admissions now begin in the ED up from 36% in 1996. For just the 11 conditions studied, Rhode Island, Delaware and Connecticut had the highest percentage of patients admitted through their EDs at 86-89%, while South Dakota, Nebraska and Kansas had the lowest admission rates. Still this makes ED function even more critical to overall hospital operation than it had been in the past. I urge all hospitals to make a serious effort to ensure that they are performing up to the standards of top hospitals. If you would be interested in a free assessment of your ED and how you are functioning compared to benchmarks, feel free to contact us at Compirion Healthcare Solutions at compirion.com.

More on this later.

Mark Brodeur