AMERICA’S EMERGENCY
CARE ENVIRONMENT

Vermont Press Release

 

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

Media Contact:
Laura Gore, 202-370-9290 
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VERMONT’S RECEIVES A D+, DECLINES IN RANKING TO 33RD PLACE, 
SHOWING A LACK OF SUPPORT FOR EMERGENCY PATIENTS

WASHINGTON — Vermont dropped to 33rd place in the nation with a D+ in the 2014 American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). A lack of statewide planning and policies in the category of Disaster Preparedness contributed to this drop. In 2009, Vermont received an overall C grade and ranked 21st in the nation.


Vermont’s Disaster Preparedness decline in both grade and rank —falling from 16th place with a B in 2009 to 40th place with an F — are principally attributable to a lack of statewide policies and a low level of volunteer capacity compared with other states. The state has no provisions for patients dependent on dialysis or medication for chronic diseases. In addition, it lacks strike teams to provide assistance during disaster or mass casualty events and has no behavioral health professionals registered in the Emergency System for Advance Registration of Volunteer Health Professionals.

“Vermont’s disaster preparedness efforts must rise to the gold standard set by Boston after the Marathon bombing,” said Dr. Peter Weimersheimer, president of the Vermont Chapter of ACEP. “The memories of Hurricane Irene in 2011 are still fresh in peoples’ minds. This Report Card should spur policymakers to ensure that every medical provider in our state is ready for anything at any time so that history doesn’t repeat itself.”

Vermont’s best grade, a 13th place ranking and a B in Public Health and Injury Prevention, reflects high immunization rates and one of the lowest infant mortality rates in the country. The state also has relatively low levels of obesity.

Vermont received a D in the category of Access to Emergency Care. Contributing to this grade include a declining pool of hospitals, emergency departments, inpatient beds and psychiatric care beds. According to the Report Card, to improve this grade, Vermont must increase its hospital capacity and reduce the long wait times (295 minutes) in emergency departments, which can lead to poor patient outcomes.

“Patients are waiting nearly 5 hours in our ERs for care,” said Dr. Weimersheimer. “The best medical care in the world won’t help you if you can’t get to it in a timely manner.”

The state’s 25th place ranking and C+ for Quality and Safety Environment are a marked improved from its 33rd place ranking and C- in 2009. Vermont continues to fund an emergency medical services medical director and has implemented stroke and heart attack systems of care. The state leads the nation in the time it takes to transfer patients with chest pain to an appropriate facility. It should continue to improve on its performance in this area by developing destination policies for stroke and heart attack patients.

Vermont also improved its grade for Medical Liability Environment from an F to a D-, although there is still significant room for improvement. The state lacks any expert witness rules requiring experts to practice in the same specialty as the defendant or to be licensed to practice in the state. To improve this grade, Vermont must support providers of federally mandated care delivered in emergency departments by offering additional liability protections that recognize the risk entailed in providing this care and requiring clear and convincing evidence of negligence in medical liability cases.

“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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