QUALITY: Poor Marks for Nation's ERs

The good news is, none of you failed. The bad news is most of you did pretty terribly.

We had flashbacks to our own collegiate career when the American College of Emergency Physicians released its National Report Card on the State of Emergency Medicine this week. (Executive Summary here, overall results here.)

Overall the U.S. earned average grade of C- reflecting performance on these five categories:

• Access to Emergency Care: D-
• Quality and Patient Safety Environment: C+
• Medical Liability Environment: C-
• Public Health and Injury Prevention: C
• Disaster Preparedness: C+

The D- in access to emergency care is particularly troubling with 12 states receiving a failing grade (see map below).

ACEP summarizes the situation well, saying:

The nation has too few emergency departments to meet the needs of a growing and aging population. Over the past decade, the number of patients coming to the nation's emergency departments annually has increased 32 percent, from 90.3 million to 119.2 million. At the same time, the number of hospital emergency departments has dropped nearly 7 percent, from 4,109 to 3,833. In addition, shortages of health care professionals at multiple levels--nurses, primary care physicians, emergency physicians, and other specialists--also jeopardize access to quality emergency care.

One way out of this mess of course could be grade inflation. But we can think of a lot better ways to solve the problem. Better management of hospital beds, admissions and discharges. Getting everyone insured so they don't turn to the ER for care. Prevention and chronic disease management, meaning fewer crises requiring emergency intervention. More access to primary care. You've heard it before — learn more here.