Reporting information on emergency department crowding to the hospital board and delivery of time-sensitive care

Megan McHugh, Raymond Kang, Alan B. Cohen, Joseph D. Restucci, Romana Hasnain-Wynia

Research output: Contribution to journalArticle

Abstract

Background: Hospital governing boards influence the quality of care that hospitals provide by holding senior leaders and managers accountable. A study was conducted to determine whether reporting data on emergency department (ED) crowding to hospital boards was associated with better performance on a time-sensitive quality measure for patients with acute myocardial infarction (AMI): Primary PCI [percutaneous intervention] Within 90 Minutes of Hospital Arrival. Methods: In a survey, hospital chief quality officers were asked whether the following data were reported to the hospital governing board: ED wait times, the percentage of ED patients who left without being seen (LWBS), and the percentage of admitted ED patients who are boarded in the ED. Responses were paired with Centers for Medicare & Medicaid Services (CMS) data on the percentage of eligible AMI patients who received PCI within 90 minutes of arrival, which served as the hospitals' PCI score. Results: In the sample of 261 hospitals, 133 (51%) of hospital governing boards received data on wait times, 125 (48%) received data on LWBS, and 63 (24%) received data on ED boarding. After hospital characteristics were controlled for, hospitals that reported data on ED boarding to the governing board had PCI scores that were 5.5 percentage points higher (that is, better); p <.05. There was no association between reporting wait times or LWBS to the board and PCI scores. Conclusion: Reporting data on the incidence of ED boarding to hospital governing boards was associated with better performance for PCI. More research is needed to explore the direction of this relationship, but the results suggest that hospitals should consider reporting data on ED boarding to their boards as a low/no-cost quality improvement activity. Copyright 2012

Original languageEnglish (US)
Pages (from-to)229-234
Number of pages6
JournalJoint Commission Journal on Quality and Patient Safety
Volume38
Issue number5
StatePublished - May 2012
Externally publishedYes

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Hospital Emergency Service
Governing Board
Research Design
Myocardial Infarction
Quality of Health Care
Medicaid
Medicare
Quality Improvement
Costs and Cost Analysis

ASJC Scopus subject areas

  • Leadership and Management

Cite this

Reporting information on emergency department crowding to the hospital board and delivery of time-sensitive care. / McHugh, Megan; Kang, Raymond; Cohen, Alan B.; Restucci, Joseph D.; Hasnain-Wynia, Romana.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 38, No. 5, 05.2012, p. 229-234.

Research output: Contribution to journalArticle

McHugh, Megan ; Kang, Raymond ; Cohen, Alan B. ; Restucci, Joseph D. ; Hasnain-Wynia, Romana. / Reporting information on emergency department crowding to the hospital board and delivery of time-sensitive care. In: Joint Commission Journal on Quality and Patient Safety. 2012 ; Vol. 38, No. 5. pp. 229-234.
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abstract = "Background: Hospital governing boards influence the quality of care that hospitals provide by holding senior leaders and managers accountable. A study was conducted to determine whether reporting data on emergency department (ED) crowding to hospital boards was associated with better performance on a time-sensitive quality measure for patients with acute myocardial infarction (AMI): Primary PCI [percutaneous intervention] Within 90 Minutes of Hospital Arrival. Methods: In a survey, hospital chief quality officers were asked whether the following data were reported to the hospital governing board: ED wait times, the percentage of ED patients who left without being seen (LWBS), and the percentage of admitted ED patients who are boarded in the ED. Responses were paired with Centers for Medicare & Medicaid Services (CMS) data on the percentage of eligible AMI patients who received PCI within 90 minutes of arrival, which served as the hospitals' PCI score. Results: In the sample of 261 hospitals, 133 (51{\%}) of hospital governing boards received data on wait times, 125 (48{\%}) received data on LWBS, and 63 (24{\%}) received data on ED boarding. After hospital characteristics were controlled for, hospitals that reported data on ED boarding to the governing board had PCI scores that were 5.5 percentage points higher (that is, better); p <.05. There was no association between reporting wait times or LWBS to the board and PCI scores. Conclusion: Reporting data on the incidence of ED boarding to hospital governing boards was associated with better performance for PCI. More research is needed to explore the direction of this relationship, but the results suggest that hospitals should consider reporting data on ED boarding to their boards as a low/no-cost quality improvement activity. Copyright 2012",
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