Washington State Earns a C, Ranks 19th, for Its Support of
Emergency Patients in National Report Card on the State of Emergency Medicine
 

State Has Mixed Results - Rankings Range from First to 43rd Across Five Categories

Seattle, WA —With the top grade in the nation for its Quality & Patient Safety Environment and a failing grade for Access to Emergency Care, Washington received an overall average grade of C for the state’s support for its emergency patients in a national Report Card released today by the American College of Emergency Physicians (ACEP).  The Report Card comes at the time when the national picture looks bleak: job and insurance losses, a rapidly growing senior population and a recent survey forecasting critical shortages of primary care doctors all point to escalating emergency patient populations.

The grades are from the American College of Emergency Physicians’ (ACEP) National Report Card on the State of Emergency Medicine, a comprehensive analysis of the support that states provide for emergency patients. The new Report Card contains more than  twice the measures of ACEP’s first Report Card in 2006, as well as a new category for disaster preparedness, which makes it more comprehensive, although not directly comparable to the previous Report Card.

The five Report Card categories (and weightings) are: Access to Emergency Care (30 percent), Quality and Patient Safety Environment (20 percent), Medical Liability Environment (20 percent), Public Health and Injury Prevention (15 percent) and Disaster Preparedness (15 percent).  In these categories, Washington ranked 43rd (F), 1st (A), 40th (D-), 4th (A), and 33rd (C), respectively.

The nation’s failure to support emergency patients resulted in an overall grade of C- for the nation as a whole.  Massachusetts earned the highest overall grade of a B, and Arkansas ranked last (51st) in the nation with a D-.  The national grade was calculated using the same methodology used for the overall state grades and is a weighted average of the nation’s category grades.

“We have a lot to be proud of in Washington in terms of this report and obviously a long way to go in some areas to support our emergency patients,” said Dr. Eric Shipley, president of the Washington Chapter of ACEP.  “We have the systems and programs in place to take wonderful care of our patients, yet we’re in desperate need of more primary care physicians and mental health providers, as well as more emergency departments overall.”

Washington’s two highest rankings came in the categories of Quality and Patient Safety Environment (1st overall) and Public Health and Injury prevention (4th in the nation); the state earned grades of A in both categories.  The state was lauded for having a uniform system for providing pre-arrival instructions for patients en route to the hospital, and every county in Washington has Enhanced 911 capability.  Washington is also implementing a stroke system of care and has in place a statewide trauma registry.  In terms of Public Health and Injury Prevention, Washington has a low rate of traffic fatalities and the second lowest infant mortality rate in the country — as well as a low percentage of adult smokers (17.1 percent).

The state’s lowest grade, F, came in the most heavily weighted category: Access to Emergency Care.  Washington ranks last in the nation in rates of staffed inpatient and psychiatric care beds, and has a great need for additional primary care and mental health providers.  The state’s rate of emergency departments per one million residents is half the average in the U.S. 

Washington did not fare well in the category of Medical Liability Environment, receiving a grade of D-, ranking 40th in the country.  The report cites the fact that Washington is one of 20 states that have not instituted a medical liability cap on non-economic damages, and does not require expert witnesses to be of the same specialty as the defendant. 

In the final category of Disaster Preparedness, Washington received an average grade of C.  The ACEP report cites a relatively low level of federal funding for disaster preparedness in the state and a lack of victim and patient tracking systems.  Washington also has the lowest rate of ICU beds in the nation available.  The state is also one of 18 states without a requirement that EMS and essential hospital personnel be trained in dealing with disasters.

“The weakened economy combined with a failing health care system mean that growing numbers of people will need emergency care,” said Dr. Nick Jouriles, president of ACEP.  “In fact, the role of emergency care has never been more critical to this nation, which is why emergency patients must become a top priority for health care reform.  We are urging President-elect Obama and the new Congress to strengthen emergency departments, because they are a health care safety net for us all.”

The recommendations of the Washington Report Card include:

• Address the critical shortages in staffed inpatient beds and psychiatric care beds.
• Enact favorable liability reforms to help address serious workforce physician shortfalls.
• Encourage medical specialists to provide on-call services to emergency departments; the state could consider special liability protections for providers of EMTALA-mandated care.
• Prepare to respond to disasters by increasing the number of ICU beds in the state.

The National Report Card on the State of Emergency Medicine was made possible, in part, by funding from the Emergency Medicine Foundation, which gratefully acknowledges the support of The WellPoint Foundation and the Robert Wood Johnson Foundation.

The Washington Chapter of ACEP is a state chapter of the American College of Emergency Physicians, a national medical specialty society representing emergency medicine with more than 27,000 members. 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.

# # #