Understanding and Improving Health System Disparities in ED Wait Times

As part of efforts to advance equity at Penn Medicine, we stratified health system performance measures by personal characteristics, such as race/ethnicity, to identify any existing disparities in care delivery. Our evaluation revealed significant disparity in Emergency Department (ED) wait times between non-Hispanic white (NHW) and non-Hispanic black (NHB) patients from arrival time to departure to admitting floor at one ED site at Penn Medicine. This finding was also noted in the Vizient performance score card.

A multidisciplinary team including entity specific Emergency Department (ED) stakeholders and health system leadership was convened to better understand this racial/ethnic wait time disparities. The team process mapped ED throughput from arrival to bed request for patients eventually admitted in effort to isolate the location of the wait time disparity. Thereafter, the team employed a sequential mixed methods analysis to characterize factors underlying the disparity. Using these findings, our team engaged key stakeholders through focus groups to develop interventions designed to address contributors to disparities in ED wait times identified by root causes identified. We are currently testing these interventions for feasibility and preliminary estimates on effectiveness.

Additionally, since the start of this project a second ED site at Penn Medicine was identified by Vizient to have the same disparity. Our team is working with an entity-specific team to determine factors contributing to this disparity and help guide subsequent interventions.

Learn more about Bias and Health Care Disparities