Hawaii Press Release


Embargoed For Release at 11 am (ET)
January 16, 2014

Media Contact:
Julie Lloyd, 202-370-9292 
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WASHINGTON — Hawaii earned an overall C- and was ranked 24th in the nation in the 2014 American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). The state earned strong grades in two categories offset by failing or near-failing grades in three.


“The admirable commitment that Hawaii’s state government shows to public health needs to be shown in other areas that affect emergency patients,” said Dr. Jay Ishida, president of the Hawaii Chapter of ACEP. “Our ability to respond to both everyday emergencies and potential disasters or mass casualty events is seriously compromised by hospital shortages and lack of burn units and ICU beds.”


Hawaii received failing grades and ranked among the bottom 10 states in both categories of Access to Emergency Care and Disaster Preparedness.


According to the Report Card, access to emergency care has been severely hampered by the closure of two hospitals in 2011. The state has a sufficient number of emergency physicians but few emergency departments, and hospitals are nearly at capacity. Patients wait on average more than 5 hours in the emergency department.


The problems with access to care hamper Hawaii’s ability to respond to disasters, which is troubling in a state surrounded by water. According to the Report Card, increasing the availability of medical facilities, ICU beds, burn beds, emergency departments and inpatient beds would go a long way toward improving the state’s access to emergency medical care and increase its ability to respond to large-scale disasters and mass casualty events.


Hawaii ranked 2nd in the nation with an A for Public Health and Injury Prevention because of low rates of chronic disease and fatal injuries. The state has high per capita funding dedicated to injury prevention and some of the lowest rates of obesity in the nation.


In the category of Medical Liability Environment, Hawaii received a D+ and ranked 30th in the nation principally because of the paucity of liability protections for the state’s health care workforce. The state could improve its grade by implementing expert witness rules requiring case certification and by instituting liability protections for care provided in the emergency department.


Hawaii’s B- in Quality and Patient Safety Environment reflects the state’s strong commitment to quality improvement and system oversight. The state has a uniform system for providing pre-arrival instructions, a state-wide trauma registry and a funded state EMS medical director.


“Hawaii’s gaps in hospital and treatment facility capacity lead to overcrowding, long wait times and an inability to respond to disasters,” said Dr. Ishida. “The best medical care in the world won’t help you if you can’t get to it in a timely manner.”


“America’s Emergency Care Environment:  A State-by-State Report Card – 2014” evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. It has 136 measures in five categories:  access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.


ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.


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