Emergency Department wait time sharing: Do patients contribute to efficiency?

Objective: Inefficiency commonly results in overcrowding of the Emergency Department (ED) and is a problem for many hospitals. When a condition of overcrowding exists, it is often associated with lower patient satisfaction, lower care quality, and decreased financial position of the hospital. To improve patient throughput efficiency, hospitals use a variety of strategies including posting ED wait times on the hospital website and the use of ED reservation systems. This study investigates these two hospital strategies used to inform patients of anticipated wait times in the ED and their associations with patient throughput efficiency. Methods: The study employs bivariate and Ordinary Least Squares (OLS) regression models to explore the associations between ED efficiency, measured by time spent in the ED, and ED wait times posted on the hospital website (Wait Times on Website) and ED time efficiency and the use of ED reservation systems. The sample includes all 176 acute care hospitals with an ED located in Florida. Results: The results of this study support that posting ED wait times has a statistically significant association with time spent in the ED; however, we did not find an association between the use of a reservation system and time in the ED. Furthermore, the control variables of hospital licensed bed size, metropolitan location, percent of population without health insurance, and percent of population Medicaid eligible were found to have associations with time spent in the ED. Conclusions: This study supports that hospitals should inform patients of anticipated ED wait times. Methods to share wait times should include posting on the hospital website, billboards, or other means to increase the likelihood of informed patients. With anticipated wait time information, the patient has the opportunity to engage in rational decision making that will positively affect ED efficiency. Healthcare leaders, including hospital administrators and ED managers, are encouraged to identify and implement better ways to inform patients of hospital performance metrics to create the opportunity for greater patient decision engagement.