WASHINGTON — West Virginia ranked 24th in the nation with a C- in the American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). The state ranked in the bottom half of the country in three out of five categories.
According to the Report Card, West Virginia ranks 42nd in the country with an F in the category of Public Health and Injury Prevention. The state is among the worst in the country for accidental poisonings (including overdoses) and childhood immunization. In addition, West Virginia has high rates of smoking, obesity and motor vehicle-related deaths. According to the Report Card, to improve this grade, West Virginia must address these issues through legislation and public education and also follow the lead set by West Virginia University, which has established the state’s only school of public health.
“West Virginia’s failing grade in the category of Public Health and Injury Prevention is a wake-up call to policymakers,” said Dr. Brett Jarrell, president of the West Virginia Chapter of ACEP. “Emergency physicians save one life at a time, while investment in injury prevention and public health can save thousands.”
West Virginia was ranked 30th in the country with a C- for Quality and Patient Safety Environment, in part because of a lack of triage and destination policies for stroke and heart attack patients. The state could improve this grade by encouraging hospitals to increase their adoption of electronic medical records, which is currently below average.
West Virginia’s C+ and 16th place ranking for Medical Liability Environment reflect the special liability protections it has enacted for federally mandated care provided in the emergency department, including a cap on non-economic damages. The state could improve this grade by establishing pretrial screening panels and requiring that expert witnesses by licensed to practice medicine in the state.
West Virginia received a C and was ranked 11th in the country in the category of Access to Emergency Care, despite its rural and mountainous geography. It has the nation’s 5th highest per capita rates of staffed inpatient and psychiatric care beds and ranks 5th in the country for unmet substance abuse needs. To improve its grade, West Virginia should work to attract and retain a higher number of emergency physicians, orthopedists, hand surgeons and plastic surgeons.
West Virginia received a D in the category of Disaster Preparedness because it lacks many important statewide disaster preparedness policies and plans. The state has one of the lowest rates of behavioral health professionals registered in the Emergency System for Advance Registration of Volunteer Health Professionals and lacks systems that allow state officials to track and respond to emerging disasters. To improve this grade, West Virginia should implement a patient-tracking system and a syndromic surveillance system.
“Our disaster preparedness is frankly a disaster,” said Dr. Jarrell. “West Virginia policymakers must focus on raising our disaster preparedness efforts to the gold standard set by Boston after the Marathon bombing.”
“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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