Shorter ER Visits: How Small Hospitals Are Leading a Quiet Revolution in Emergency Care
The national average emergency department (ED) visit time dipped to 161 minutes in 2024, a slight improvement from 163 minutes the year prior. But while that national figure offers a broad overview, a closer look reveals a surprising trend: the fastest-moving ERs aren’t typically found in bustling city trauma centers, but in smaller community and critical access hospitals. This shift isn’t just about luck; it signals a potential reshaping of emergency care delivery, and understanding why is crucial for hospitals of all sizes.
The Speed Leaders: A Look at the Data
Recent data compiled by Becker’s, utilizing CMS’ Timely and Effective Care-Hospital data, highlights hospitals achieving remarkably swift turnaround times. Leading the pack is Rio Grande Hospital in Del Norte, Colorado, with a median ED length of stay of just 45 minutes. Mille Lacs Health System in Minnesota closely follows at 46 minutes. Here’s a snapshot of the top 10, alongside their 2023 times for comparison:
| Hospital/Health System | Median ED Length of Stay (2024) | Sample Size | Previous Median ED Length of Stay (2023) | Sample Size |
|---|---|---|---|---|
| Rio Grande Hospital (Del Norte, Colo.) | 45 minutes | 174 patients | 38* minutes | 176 patients |
| Mille Lacs Health System (Onamia, Minn.)* | 46 | 231 | 44 | 25 |
| Mitchell County Hospital District (Colorado City, Texas) | 48 | 392 | 54 | 05 |
| Myrtue Medical Center (Harlan, Iowa) | 52 | 373 | 52 | 82 |
| Coteau Des Prairies Health Care System (Sisseton, S.D.) | 53 | 342 | 64 | 98 |
| Richardson Medical Center (Rayville, La.) | 53 | 377 | 56 | 402 |
| Lady of the Sea General Hospital (Cut Off, La.) | 54 | 380 | 42 | 191 |
| Pinckneyville (Ill.) Community Hospital | 56 | 189 | 54 | 129 |
| Cuba Memorial Hospital* | 57 | 466 | 83 | 35 |
| Mercy Hospital Tishomingo (Okla.) | 58 | 358 | 58 | 368 |
*Data is based on a shorter time period than required, according to CMS.
Why Smaller Hospitals Excel in ED Efficiency
The success of these smaller facilities isn’t a coincidence. Several factors contribute to their streamlined processes. Lower annual ED volumes mean less congestion and shorter wait times. Furthermore, these hospitals often treat patients with less complex medical needs – a lower “case mix index” – allowing for quicker diagnoses and treatment plans. However, it’s important to note that CMS data doesn’t currently account for these volume and acuity differences, potentially skewing comparisons.
The Power of Established Relationships & Integrated Care
Beyond volume, community hospitals often benefit from strong relationships with local primary care physicians. This facilitates better communication and coordinated care, reducing unnecessary ED visits and ensuring patients receive appropriate follow-up. Many also integrate behavioral health services directly into the ED, addressing a growing driver of longer wait times in larger facilities. This integrated approach to emergency department care is becoming increasingly vital.
The Future of Emergency Care: What Larger Hospitals Can Learn
While Level 1 and 2 trauma centers will always be essential for handling the most critical cases, the success of these smaller hospitals offers valuable lessons. Larger facilities can explore strategies to emulate their efficiency, such as:
- Implementing “fast track” systems: Dedicated pathways for patients with minor ailments can significantly reduce overall wait times.
- Expanding telehealth options: Virtual consultations can triage patients and address non-urgent concerns remotely.
- Investing in point-of-care testing: Rapid diagnostic tests can accelerate the decision-making process.
- Strengthening partnerships with primary care: Improved communication and care coordination can reduce avoidable ED visits.
The Role of Technology and AI in ED Optimization
Looking ahead, technology will play an even greater role in optimizing emergency care. Artificial intelligence (AI) powered tools can predict patient flow, identify potential bottlenecks, and assist with clinical decision support. Real-time location systems (RTLS) can track patients and equipment, improving resource allocation. These advancements, coupled with a focus on process improvement, will be crucial for all hospitals striving to deliver timely and effective care. The use of predictive analytics in ED wait times is a growing field.
Beyond Speed: The Importance of Timely and Effective Care
Ultimately, the goal isn’t just to shorten ED visit times, but to provide timely and effective care. The CMS data underscores the importance of this metric, and hospitals are increasingly being held accountable for their performance. By learning from the successes of smaller facilities and embracing innovative technologies, all hospitals can improve the patient experience and ensure that everyone receives the care they need, when they need it. Focusing on patient flow and ED efficiency will be paramount.
What strategies do you believe will be most effective in reducing ED wait times in the coming years? Share your thoughts in the comments below!
