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EMERGENCY DEPARTMENTS: EDBA database provides utilization benchmarks by patient volume for US hospitals

The Emergency Department Benchmarking Alliance collects utilization data currently from nearly 1,000 emergency departments in the U.S.  That’s a pretty robust sample, representing roughly a quarter of the emergency departments in the nation.  The two tables that I will describe below have data from these participating EDs segmented by size — by annual volume, that is.  You can examine the difference between low-volume and mid-volume and high-volume EDs.  Let’s look at a few of these metrics.  The first group represents data for the time period 2004 through 2010.

Percent of ED patients admitted to the hospital

  • 11.2 percent (low volume, less than 20,000 patients/year)
  • 21.8 percent (high volume, greater than 80,000 patients/year)

Percent of ED patients who arrived by EMS

  • 11.5 percent (low volume)
  • 21.4 percent (high volume)

Median length of stay for ED patients who are not admitted to the hospital

  • 107.4 minutes (low volume)
  • 213.1 minutes (high volume)

Median length of stay for ED patients who ARE admitted to the hospital

  • 215.7 minutes (low volume)
  • 386.0 minutes (high volume)

Patients who left before treatment complete (LBTC)

  • 1.3 percent (low volume)
  • 3.4 percent (high volume)

Percent of ED patients admitted to the hospital (updated, 2012 data only)

  • 12.0 percent (low volume, less than 20,000 patients/year)
  • 18.6 percent (high volume, greater than 100,000 patients/year — note that this is a little different group than what was reported above)
  • 16.4 percent (TOTAL)

There is another great article that also looks at data from this data source, segmented by patient volume.  I’ve blogged about it before, but it is worth a mention here.  See #3 below.

Sources: 

1. Handel, D., Augustin, J.J., and others.  Comparison of emergency department operation metrics by annual volume over 7 years.  Academic Emergency Medicine;19(4, Supplement 1):S32-S33, Apr. 2012.  Click here for access to full text:  http://www.edbenchmarking.org/uploads/aem.pdf

2. Martinez, R., and Carr, B.  Creating integrated networks of emergency care: from vision to value.  Health Affairs;32(12):2082-2090, Dec. 2013.  Click here http://content.healthaffairs.org/content/32/12/2082.abstract?rss=1&related-urls=yes&legid=healthaff;32/12/2082  

3.  Welch, S.J., Augustin, J., and others.  Volume-related differences in emergency department performance.  The Joint Commission Journal on Quality and Patient Safety;38(9):395-402, Sept. 2012.  Click here for access to full text: http://www.edbenchmarking.org/uploads/jcjqps-size-matters-welch-preproofreadiing.pdf Posted by AHA Resource Center (312) 422-2050, rc@aha.org

ED: Operational benchmarking statistics by patient volume

One of my favorite things is to skim through an article and discover a table with great data.  We’ve got it here.  The data are based on comparative utilization and operational statistics collected by the Emergency Department Benchmarking Alliance from 358 participating hospitals — representing over 14 million emergency department visits.  Table 3 is the one that got me excited.  Here are the ED metrics included:

  • ED Patients / day
  • Percent with high CPT acuity rate
  • Percent pediatric patients
  • Admission rate
  • Transfer rate
  • EMS arrival rate
  • EMS arrival admission rate
  • Hospital admission through the ED rate
  • Patients per care space
  • ECGs / 100 ED visits
  • X-ray studies / 100 ED visits
  • CT/MRI studies / 100 ED visits
  • LBTC (left before treatment completed) rate
  • Door-to-physician time
  • ED length of stay for admitted patients
  • ED length of stay

And it gets even better — these metrics are in 5 different size categories — from the low-volume emergency departments with under 20,000 annual ED visits up to the high-volume with over 80,000. 

The findings of this research were that for certain emergency department operational performance measures, bigger (higher volume) is not better.

Source: Welch, S.J., and others.  Volume-related differences in emergency department performance.  The Joint Commission Journal on Quality and Patient Safety;38(9):395-402, Sept. 2012.  Click here for the publisher’s website:  http://www.ingentaconnect.com/content/jcaho/jcjqs  Click here to link to the Emergency Department Benchmarking Alliance website: http://www.edbenchmarking.org/index.php Posted by AHA Resource Center, (312) 422-2050, rc@aha.org