A national study on the average hospital emergency department wait time since 2015 may have confirmed what many local patients have experienced.

Patients in Forsyth County's two emergency departments waited on average between nearly five hours to just more than six hours before being  admitted, according to federal medical data reviewed by ProPublica.

For those emergency room patients who were treated and sent home, it still took around three hours to complete the process.

The wait time measures what the Centers for Medicare and Medicaid evaluates as “timely and effective care.” ProPublica said “average time refers to the median wait time — the midpoint of all patients' wait times."

Most individuals seeking treatment at an emergency room typically are seen initially by a doctor or medical practitioner.

"While timing can vary depending on why someone came to the ER — a sprained ankle may take less time to treat than unexplained chest pain — long wait times are often signals of overcrowding or staff shortages," ProPublica said.

As has been the case during some recent flu seasons, the wait time can be even longer during higher exposure times in December through February.

The average wait time at Forsyth Medical Center was 4 hours and 51 minutes for those who were admitted, and 2 hours and 48 minutes for those examined and released.

By comparison, the average wait time at Wake Forest Baptist Medical Center was 6 hours and 13 minutes for those who were admitted, and 3 hours and 8 minutes for those examined and released.

For Moses Cone Hospital in Greensboro, the average wait time was 5 hours and 55 minutes for those who were admitted, and 3 hours and 26 minutes for those examined and released.

"Novant Health is not familiar with the ER Inspector report and cannot comment on its value to consumers without a better understanding of the measures included and how that information can be used to provide the best possible care for our patients," a Novant Health spokesperson said. "Patient safety is paramount to Novant Health and we encourage patients to use all available resources to identify which health care decisions are right for them."

Wake Forest Baptist could not be immediately reached for comment on the wait time report.

Kenneth Rempher, Cone Health's executive vice president of acute care services and chief nurse executive, said that "for those (patients) with less critical conditions, we have seen good early results from pilot projects in reducing wait times in our emergency departments."

"We continue to expand options for convenient care in our community, including telemedicine, urgent care and primary care.”

The study also reviewed the transfer time, also known as boarding time, that measures how long it takes to go from being admitted to situated in a hospital room.

That time was 2 hours and 19 minutes at Wake Forest Baptist, 1 hour and 43 minutes at Forsyth and 2 hours and 52 minutes at Moses Cone.

Also measured was how many individuals left the emergency room before being examined. That rate was 5% at Wake Forest Baptist, 2% at Forsyth, 3% at Moses Cone, and 3% statewide.

Other findings

ProPublica also reported on the number of emergency room-related violations, as identified during the investigation of a complaint.

Hospitals that participate in Medicare are subject to health and safety regulations that include inspections on a non-yearly basis. They also are evaluated on how they respond to consumer complaints.

Medicaid "only publicly releases violations found during the investigation of a complaint," ProPublica said.

The group said violations primarily come from not properly assessing and treating patients, inadequate medical and nursing staff, and not following emergency room policies and procedures.

It also includes violations of the Emergency Medical Treatment and Active Labor Act, which requires emergency rooms to provide a medical screening examination and treatment to stabilize anyone who comes to the emergency department, regardless of their ability to pay.

Wake Forest Baptist was found to have had five violations since January 2015, while Forsyth had none and Moses Cone two.

The five at Wake Forest Baptist was tied for the most by an urban hospital in the state with Rex Healthcare in Raleigh.

ProPublica said the study can be used as a tool for determining where to seek non-life-threatening care in a hospital emergency department.

The group warned that "if you think you are having a heart attack, stroke or other life-threatening emergency, do not use ER Inspector. Call 911 and seek care immediately."

In 2018, Medicare removed a measure of the average time patients with broken bones had to wait before receiving pain medications.

It made that decision based mostly on concerns that the measure “may create undue pressure for hospital staff to prescribe more opioids.”

"Experts caution that very small differences between hospitals for a given measure are unlikely to correspond to noticeable differences in the real world," ProPublica said.

Billboards

Several health-care systems, including Novant Health Inc., have used billboards along interstates and major highways to provide emergency room wait times.

Novant deployed the strategy for its Clemmons, Forsyth, Kernersville or Thomasville medical centers. The billboards provided the average wait time over an hour period, with the time updated every 15 minutes.

The systems also post wait times for individual hospitals on their websites.

Those times "represent the estimated average amount of time from entering the emergency department to being placed in a treatment area," Wake Forest Baptist said on its website.

In most instances, those wait times typically range from 15 minutes to an hour.

"Cone Health never posted emergency department wait times online," spokesman Doug Allred said. "We did post urgent care wait times for a while."

The billboards were part of a national trend with no set standard for how wait times are defined, according to industry and advocacy groups.

Numerous reports have presented the pros and cons of the initiative, with most recommending caution by health-care systems and consumers.

Some hospitals offer an online service to allow individuals to secure a reserved time at an urgent-care center.

The Emergency Medicine Residents’ Association said the federal government is playing a role in the billboards strategy by tying emergency-department wait times to Medicare and making the times available at www.hospitalcompare.hhs.gov.

“Although supported by the government, there are many in the medical community who oppose advertising wait times,” the association said. “One argument is that hospitals which advertise wait times do so simply to lure patients away from competing hospitals.”

The American College of Emergency Physicians report found that “publication of desirable wait times engenders goodwill with hospital administration and improves the image of the ED within the surrounding community.

“In essence, the practice of publishing wait time data may theoretically assist with workload distribution without losing revenue for the system as a whole.”

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