With increased risks of food poisoning, burns from cooking, car accident injuries and the rise of wintertime ailments like the flu, the holiday season can result in more trips to emergency rooms.
But in Maryland, higher rates of emergency room visits may exacerbate an existing issue: it can take hours or close to a day between arriving at the emergency room and actually receiving care. State and local officials are trying to determine why emergency room wait times are so long in Maryland.
Wait times in the state are longer than the national average, according the Maryland Health Services Cost Review Commission, which oversees and regulates hospital rates in the state.
According to September data, the shortest median wait time, from arrival to inpatient admission, was about 3.3 hours, or just over 200 minutes, at Atlantic General in Berlin on the Eastern Shore. In 2020, the median emergency room wait time in the United States was 286 minutes, or 4.7 hours, according to U.S. News.
September data for Maryland show that Atlantic General was the only emergency department that fell below what was the national median in 2020. The remaining 39 emergency rooms reported a median wait time of over 5 hours.
And some of the longest wait times in Maryland can take almost a whole day, according data from the commission.
That includes the University of Maryland Medical System’s emergency department in Easton. In September, the UM Shore Medical Center saw a median wait time of 1,400 minutes, just under 24 hours, from when a patient arrived at the facility to when they are admitted.
The next longest median wait time was Johns Hopkins Bayview Medical Center in Baltimore, with over 16 hours from arrival to inpatient admission in September. MedStar Harbor Hospital’s in Baltimore emergency department had a 700 minute median wait time — more than 11 hours. Those three emergency departments had the longest wait times and each reported a “high volume” of patients during the data collection period.
And wait times don’t include how long it takes to receive care for any injury or ailment that brought you to the emergency room.
The Health Services Cost Review Commission has collected “aim statements” from emergency departments to help track how each facility will work towards improving wait times.
Johns Hopkins Bayview says it plans to reduce the wait time “between when a patient is assigned to a unit/bed on selected services and the time the patient departs the Emergency Department by 10% by March 30, 2024.”
Atlantic General has a couple smaller goals. It wants to reduce by 1% the number of patients who left before being seen by a physician and achieve a median length of stay of 120 minutes or less by March 1, 2024.
While not all emergency departments made clear how they would accomplish those goals, many hospitals said that they will rework the discharge process in order to improve turnaround times, therefore allowing patients to be seen more quickly.
Prince George’s County task force
The longstanding issue of long wait times in emergency rooms is pervasive across the state, and some counties are working independently to correct the issue.
Last week, the Prince George’s County Council approved a new workgroup to research and resolve long wait times, and that process can shed light on the complexity of trying to solve the issue.
Council Vice Chair Wala Blegay (D) sponsored the resolution and noted that the issue of long emergency room wait times are due to a variety of factors, and that there may be several ways to alleviate the issue for Prince George’s County
“We had many stakeholders come here and talk about emergency room wait times, and we’ve all heard from residents throughout the county complaining about emergency room wait times,” she said at the Nov. 14 meeting.
“But we have one of the longest wait times in the country and even in the state. So we have to do something, and this is us taking the first step,” Blegay added.
While crafting the resolution, issues with health care staffing, patient turnaround, and the number of primary care physicians were all raised as factors that result in extended waiting room times.
Eunmee Shim, president of Adventist Healthcare Fort Washington Medical Center, told the council that people without regular access to primary care physicians will be more likely to use medical services at an emergency room.
What results is called “boarding” of patients, which is when emergency departments have patients who are awaiting care stay in the hallways until a room is available.
“High occupancy rate of hospital beds in the community, starts to create a symptom called ‘boarding’ of the patents in emergency rooms,” Shim told the county council.
“We need more providers in the community where people can get their care through physicians in their offices, not in emergency rooms,” she added.
But Jibran Eubanks, political organizer with 1199 SEIU, raised another issue: the ability to staff emergency rooms.
“Worker to patient ratios in our hospitals are unsustainable and, due to the chronic short-staffing, healthcare workers are overworked and underpaid,” he said. “Patients’ health will continue to suffer if ER wait times remain overly long due to the mismanagement of hospitals which is leading to high turnover for employees.”
For example, he noted that when a room becomes available because a patient has been transferred or discharged, the room needs to be sterilized before the next patient arrives. If there are not enough workers on hand to clean the facility then the turnaround time will be longer.
Prince George’s County’s 17-person task force is to be comprised of hospital representatives, a state delegate or senator representing Prince George’s, nurses, emergency room staff and an emergency room physician, among others.