Mar 18
2024
Arming Patients with Accurate Medical Information To Improve ER Outcomes, Wait Times
By Jennifer Devening, CEO, YourHealth.
In the controlled chaos of the emergency room (ER), time and accuracy are of the essence. Not only do they impact care outcomes, but also quality, safety, costs, and patient satisfaction. With wait times and costs for emergency care rising, the ER is a prime target for efficiency, productivity, and cost improvement strategies.
The state of the ER
Of the nearly 140 million annual ER visits reported by the Centers for Disease Control & Prevention, more than 13% resulted in admission. Less than half (~42%) of patients were seen in fewer than 15 minutes. What’s more, driven by staffing shortages and higher demand, ER wait times are creeping upwards, increasing to 2 hours and 40 minutes in 2022 from 2 hours and 35 minutes in 2021.
Those same headwinds are driving up ER costs. According to Syntellis, ER labor costs increased by nearly 50% between January 2020 and January 2023 even as ER visits declined by 9.5% over that same period. One casualty of overcrowded and understaffed ERs is accuracy, particularly when it comes to patient histories.
One recent study concluded that medication histories performed in the ER are largely inaccurate and incomplete after finding discrepancies in 27% of medication lists obtained during triage. Of those, nearly 10% involved discontinued medications and nearly 28% involved missing medications. Thirty-eight percent of patients reported taking a non-prescription medication not listed in their electronic medical record.
Given the percentage of ER visits resulting in admission, errors made during ER triage carry through to impact safety and outcomes for inpatients. One study found that up to 67% of patients admitted to a general medical ward had at least one error associated with their medication history.
Further, inaccurate or incomplete medication histories can lead to adverse drug reactions (ADRs), which can prolong hospital stays by anywhere from 1.5 days to nearly five days, according to the U.S. Department of Health and Human Services. ADRs are attributed to approximately 6.5% of all hospital admissions, many involving drug-drug, herbal, and/or supplement interactions.
Many of these medical safety errors result from inadequate reconciliation during admission, with one medical center estimating that approximately one in 10 patients with inaccurate medication lists are likely to suffer an adverse drug event (ADE) that causes physical or mental harm or loss of function. ADEs are also associated with longer hospital stays and higher care costs.