WASHINGTON — Washington dropped to 35th place in the nation with a D+ in the American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). Despite ranking in the top 10 states in the categories of Public Health and Injury Prevention and Quality and Patient Safety, Washington received failing grades in three out of five categories. In 2009, the state ranked 19th in the nation with a C.
"Washington's dismal grade in the arena of Disaster Preparedness is disappointing", said Dr. Christopher Kang, president of the Washington Chapter of ACEP. "Together, with our policymakers and community leaders, in light of recent events such as the Boston Marathon bombing, we must reprioritize our commitment to Disaster Preparedness to better serve and care for the people of Washington State."
Washington’s failing grade in the category of Disaster Preparedness reflects a drop in per capita spending on disaster preparedness from $7. 09 to $5. 31. According to the Report Card, Washington could improve its grade and ranking by creating a statewide medical communication system with redundancy and by recruiting more physicians, nurses and behavioral health professionals to register in the Emergency System for Advance Registration of Volunteer Health Professionals before disaster strikes.
Although the state improved its rank in the category of Access to Emergency Care (since 2009), Washington still received a failing grade in this category, in part because of a severe lack of resources and inpatient capacity for mental health patients. The state also has some of the lowest levels in the nation of staffed inpatient and intensive care unit beds. According to the Report Card, to improve its grade, Washington must make greater investments in hospital infrastructure.
Washington received an F in the category of Medical Liability Environment related to having few protections for the state’s medical practitioners. The state could improve its grade by passing a medical liability cap on non-economic damages and by offering special liability protections for federally mandated medical care provided in emergency departments.
In the remaining two categories, Washington ranked in the top 10 states in the country.
Washington is a leader in quality initiatives, such as triage guidelines for heart attack, trauma and stroke patients. It also has a strong prescription drug monitoring program and continues to fund quality improvement efforts within the emergency medical services system. As a result, the state’s B for Quality and Patient Safety ranked it eighth in the country.
"Washington is exemplary in numerous areas such as injury prevention and patient safety environment, but the dismal grades in these three categories are disconcerting and are an urgent wake-up call to reinvigorate our efforts to keep pace with new initiatives already being implemented across the country."
The low rates of fatal injuries and generally low levels of chronic disease risk contributed to Washington’s A- and 5th place ranking for Public Health and Injury Prevention. The state is first in the nation for seatbelt use and the infant mortality rate is among the lowest in the country.
“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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