Issue link: https://beckershealthcare.uberflip.com/i/1539852
17 QUALITY IMPROVEMENT & MEASUREMENT ED boarding times worsen: 7 notes By Mariah Taylor M ore patients who require hospitalization are waiting hours or days in emergency departments for a bed to open, and the trend has grown worse the past four years, researchers at the University of Michigan Medical School in Ann Arbor and the Beth Israel Deaconess Medical Center in Boston found. e study, published in June in Health Affairs, used data from 46 million emergency visits that led to hospitalizations from EHR systems at 1,500 hospitals from all 50 states. Analyzed hospitalizations took place from 2017 to September 2024. e boarding problem was already worsening before COVID-19 pandemic, but it has remained high for the last four years, and not just during peak viral seasons. National hospital standards indicate a patient should not board for more than four hours for safety and care quality reasons, according to an Aug. 4 Michigan Medicine news release. Boarding also leads to steep financial implications for health systems. In 2024, at least two health systems — Portland-based Oregon Health & Sciences University and San Diego-based Scripps Health — linked financial challenges to ED overcrowding. Here are seven study findings: 1. In the last three years, more than 25% of patients who appeared at an ED during a non-peak month waited four hours or more for a bed. During the winter months, that number rose to 35%. 2. Waiting 24 hours or longer for a bed used to be rare, but by 2024, nearly 5% of all patients admitted to the hospital during peak months waited 24 hours for a bed. In off-peak months, that number was 2.6%. 3. Even in months with the lowest rates of boarding patients in 2024, the percentage of patients who waited four or more hours for a bed was higher than during the worst times in 2017 to 2019. 4. Before the pandemic, fewer than 5% of patients waited more than 12 hours for a bed even during peak times, now it rarely goes below 5% even at the lowest times of year, the study said. 5. January 2022 had the worst boarding times: 40% of patients boarded in the ED for more than four hours and 6% boarded for 24 hours or longer. 6. e Northeast had the highest rate of boarding for 24 hours or more. 7. Boarding during peak months rose quickly for patients 65 and older, those whose primary language was something other than English or Spanish, and Black patients. n Complaints against hospitals grow 79% in 5 years: CMS By Paige Twenter M ore than 14,500 complaints were lodged against hospitals in fiscal 2024, a 79% increase in complaints compared to fiscal 2019, according to a CMS report published Aug. 6. Federal CMS annually assesses each state CMS survey agency on how they enforce national regulations on healthcare facilities. Despite resource and workload challenges, state agencies' funding has remained unchanged since 2019, the report said. In the last five years, the number of complaints requiring investigation has risen 31.3%. Most complaints concerned nursing homes, which were upward of 107,000, according to the report. In 2024, almost all states failed to meet all federal performance standards. Only four states met all 14 survey and intake measures: Louisiana, Montana, North Dakota and Rhode Island. n