Data: Longer wait times at LVHN ERs
But total hours can depend on severity of illness
Patients who visited a Lehigh Valley Health Network-operated emergency department usually spent more time waiting for and receiving care before going home than the statewide average, federal data shows.
Using data from the Centers for Medicare & Medicaid Services for 2021, the latest the data is available, The Morning Call tracked down the median time patients spent in a hospital emergency department before going home for 10 hospitals in the Lehigh Valley and beyond, as well as St. Luke’s Warren campus in Phillipsburg, New Jersey. St. Luke’s Anderson, which recently completed an expansion to its emergency department, was excluded.
The CMS data shows the total amount of time patients spent in the emergency department before going home not just the amount of time spent waiting.
The shortest patient care times were at the emergency departments of St. Luke’s Easton campus and Geisinger St. Luke’s Hospital in Orwigsburg with the median care time for both at 2 hours, 2 minutes. The longest was Lehigh Valley Hospital-Hazleton with patients spending a median 3 hours, 52 minutes in the hospital’s emergency department before going home.
The CMS data shows that most LVHN-operated hospitals had longer median care times than the state or national median times. However, the median care times for patients at most St. Luke’s operated EDs, was lower than the national and state medians.
Though the CMS data shows patients spent more time in LVHN emergency departments before going home, Brian Downs, spokesperson for LVHN, said in some cases there is a reason for this. A longer length of care is often indicative of sever
ity of illness rather than time spent waiting for care. He said it makes sense that total care times at Lehigh Valley Hospital-Cedar Crest would be high as it is the only combined adult level I and pediatric level II trauma center and burn center in the region and is only one of two in the state.
“Patients at higher level comprehensive academic medical centers, such as Lehigh Valley Hospital-Cedar Crest, often require more complex and specialized care, which may also result in needing care for a longer period of time,” Downs said.
Nationally and statewide about 2% of patients left the emergency room without being seen, but nearly all LVHN and St. Luke’s performed better in this regard, with 1% or fewer patients leaving without being seen at most hospitals. No hospitals from either network saw more than 2% of patients leave before receiving care.
The data CMS uses for ER visit times comes from the Hospital Inpatient Quality Reporting program, which includes the information from Medicare, Medicare managed care patients, and non-Medicare patients. Information also comes from the Veterans Administration and the Department of Defense.
Though CMS’ data can give patients an idea of how long they might wait at a given hospital there are some caveats. One is that the current data CMS is sharing only covers 2021. Downs added that for LVHN, 2021 was a period where its hospitals were caring for a large share of the region’s sickest COVID patients.
Another way the data doesn’t tell the full story is that while it indicates if a hospital’s emergency department sees very high, high, medium and low patient volumes on an annual basis, it does not account for other relevant factors like the level of trauma certification or other specializations.
The other big caveats are that not all patients will wait the same amount of time for care and others will need more medical care than others. Sam Kennedy, spokesperson for St. Luke’s, said generally patients are seen in the order they come in but the triage process helps the hospital determine who is the sickest or in the most severe condition and needs to be moved ahead of the line.
If there are open beds patients will be taken to a room as they arrive. But if no space is available that is when a triage nurse will use a standardized procedure to evaluate vital signs, patient history to determine the severity of symptoms.
There are other factors that affect wait and care times, including the time of the year. Hospitals see higher patient volumes in their EDs when there are high levels of community spread for illnesses like influenza or COVID-19, such as late fall and the bulk of winter.
Kennedy said during these times, patients who tend to wait the longest are those who have a common illness like flu, COVID or respiratory syncytial virus but are not experiencing serious complications. He said St. Luke’s recommends that people who are sick but don’t have severe symptoms contact their primary care provider. Most urgent cares in the region are also capable of providing routine testing or prescriptions related to symptomatic relief.
“This will ensure our patients with emergency needs such as shortness of breath, chest pain, abdominal pain, stroke, trauma and other emergency symptoms have rapid access to care in our emergency departments,” Kennedy said. “Appropriate use of healthcare resources is vital to ensuring patients with the highest level of need have immediate access to that care in the emergency department.”