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    Study: ER Patients Wait Too Long for Care

    Many Hospitals Aren't Meeting Their Own Goals for Limiting Wait Times in Emergency Rooms

    Misuse of Emergency Departments continued...

    Schneider is vice president of the American College of Emergency Physicians and she practices emergency medicine at Strong Memorial Hospital in Rochester, N.Y.

    "When people come to emergency departments [EDs] and have to wait, they assume this is unusual and that people coming to the EDs for primary care are to blame," she tells WebMD. "What they don't realize is that EDs are crowded 24/7 and it has little to do with people using them for primary care."

    One problem, she says, is that emergency departments have become dumping grounds for patients waiting to be admitted to the hospital and even those who have already been admitted.

    She tells the story of a hospitalized woman whose condition worsened to the point where she needed to be admitted to the intensive care unit (ICU).

    The ICU had beds, but no available nurses to take care of her because the hospital limited ICU nurses to two patients each.

    "The solution was to send her to the emergency department where her nurse was already taking care of two other ICU patients, three other hospitalized patients and three emergency patients," she says. "I wouldn't say that cases like this are routine, but they aren't rare either."

    Emergency department crowding has become so severe that the National Academy of Sciences called it a "national epidemic" in a 2006 report.

    Horwitz says her study and others suggest that individual hospitals can do a lot to address the problem.

    Improving efficiencies within hospitals has taken center stage in the debate over health care reform, and Horwitz says there is a good reason for this.

    "As we look more closely at how hospitals actually work -- how they register and discharge patients, schedule elective surgeries, and things like that -- I think we will find that these things make a huge difference in how effective and efficient hospitals are," she says.

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