Thursday, August 5, 2010

When reporting about a displayed statistic, look at the statistic!

Joel Garry happened to see my Wednesday post that discussed the Placentia-Linda Hospital website. If you missed this post, it mentioned (among other things) the fact that the hospital is displaying its emergency room wait time on the website (with the caveat, of course, that emergencies are always treated based upon "the magnitude of illness or injury").

Garry referred me to a recent article on emergency room wait times. Specifically, the article looks at ways in which wait times can be reduced, which is particularly difficult when the number of visits to emergency rooms are increasing at a rate of 5-10% per year.

Scripps Mercy Chula Vista decreased its average wait times from 87 to 25 minutes by changing its processes:

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The hospital has dropped the traditional triage nurse who takes medical information, assesses a patient’s situation and whisks critical cases inside while returning non-acute patients to the waiting room. Now, the Scripps Mercy waiting room has become a quick-stop lobby where patients are immediately taken to a “blue side” for true emergencies or to a non-acute “gold side.”

On the blue side, a traditional approach is taken, with one nurse caring for no more than four patients, as required by state law.

The big change is on the gold side, where patients quickly meet with a nurse-and-doctor team to be evaluated. A treatment nurse coordinates any tests or procedures and a discharge nurse handles the final details before the patient heads out the door. Rather than one nurse caring for four patients, each nurse is [assigned] a specific task so patients rotate through more quickly....

And the hospital is doing other things, such as replacing gurneys with recliners. 40 recliners take up the same square footage as 29 gurneys, thus enabling the hospital to service more patients.

But do these changes truly work? I consulted the leading authority on hospital reputations, Yelp. (Hey, I'm a Reed College graduate; U.S. News and World Report is not an option.) Unfortunately, there are no 2010 reviews of Scripps Mercy Chula Vista, but the June 17, 2009 review indicated that something truly needed to be done.

I was here all day and because of a mixup with the nurses, I was here somewhere between 1-2 hours longer than needed. That's ridiculous, no, UNACCEPTABLE when you think about the consequences of a more serious mistake. We are all human but that doesn't make my experience any more unsettling.

Hopefully Scripps Mercy Chula Vista has addressed these issues, although we can't be sure; they don't display their wait times. (Although I question whether that statistic in isolation is truly meaningful; I should return to that topic later.)
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