Additional Resources

Robert Wood Johnson Foundation: The Synthesis Project, Emergency Department Utilization and CapacityJuly 2009

The hospital emergency department (ED) plays a unique and important role in the American health sector and broader society. EDs are designed to treat the most critically ill and injured patients and they are part of the first response to public health emergencies such as natural disasters and terrorist attacks. In addition, EDs also serve as a bellwether of performance in other parts of the health care system. For example, limited access to primary care often reveals itself in non-urgent or preventable care provided in the ED (125, 14, 135).1 The availability and utilization of ED care can reveal limitations in other areas such as inpatient and psychiatric capacity. The ED has also been described as the "safety net for the safety net" as it is the one place where patients know they can be seen regardless of financial resources or time of day (146).

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GAO-09-374: Hospital Emergency Departments, Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames, April 30, 2009

Open 24 hours a day, 7 days a week, hospital emergency departments are a major part of the nation’s health care safety net. Of the estimated 119 million visits to U.S. emergency departments in 2006, over 40 percent were paid for by federally-supported programs.1 These programs— Medicare, Medicaid, and the State Children’s Health Insurance Program2— are administered by the Department of Health and Human Services (HHS). Emergency department staff report being under increasing pressure, and concerns have been raised that they face challenges in providing timely and effective emergency medical care.

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NQF ENDORSES MEASURES TO ADDRESS CARE COORDINATION AND EFFICIENCY IN HOSPITAL EMERGENCY DEPARTMENTS, October 29, 2008

Measures can help decrease wait time, increase physician productivity, and safetyWashington, DC - To reduce overcrowding, decrease patient wait time, and improve quality of care, the National Quality Forum (NQF) endorsed 10 national voluntary consensus standards for hospital-based emergency department care. The measures aim to improve efficiency and care coordination in emergency departments where high demand and capacity issues have increased patient wait time and decreased physician productivity.

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CDC Releases New Emergency Department Data, August 6, 2008

The National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC), has released a new report on emergency department (ED) utilization in the United States. The report contains data from the 2006 National Hospital Ambulatory Medical Care Survey (NHAMCS). According to the report, between 1996 and 2006, the annual number of ED visits in the United States increased by 32 percent. However, the number of hospital EDs has decreased from 4,019 to 3,833 (5 percent), resulting in more visits per ED and increased wait times. 

To view the NCHS ED Report, click here.


Assessing Health and Health Care in the District of Columbia February 7, 2008 

RAND, in partnership with the George Washington University Department of Health Policy, recently released a working paper describing interim findings from a study of health and the health care service delivery system in the District of Columbia. The goals of the study are to: (1) conduct a comprehensive health needs assessment for Washington DC; (2) assess the quality and accessibility of the District’s health care delivery system for individuals with urgent or emergent medical needs; and (3) use information from those assessments to identify and assess various policy options for improving the health care delivery system. This document summarizes findings related to the first two goals. A final report will include findings relevant to goal three. 

To view the working paper, click here. 


Emergency Department Performance Measures: Creating Consistency in a Chaotic Environment  November 15, 2006 

In February 2006, nineteen influential members of the emergency medicine community met in Atlanta to discuss and develop performance measures for the emergency department (ED). The purpose of the meeting was to begin the process of standardizing the terminology and implementation of ED performance measures that will serve as markers of operational quality. The resulting Consensus Statement produced by the Atlanta summit is being circulated among the emergency medicine community for comment and discussion. Additionally, this report was recently published in Academic Emergency Medicine: Acad Emerg Med. 2006 Oct; 13(10):1074-80. 

To view the report, click here.