On Thursday, January 16, ACEP issued its 2014 Report Card on America’s Emergency Care Environment. I would anticipate many of you have already read all or portions of it, and most of you have seen or heard it bandied about on the airwaves or in some form of print media. One of the primary reasons for the Report Card—and for actively publicizing it—is that it’s a useful tool in educating the public and policymakers in order to effectively advocate for the changes we need to provide our patients with the best possible care.
This is the 3rd iteration of the Report Card, previously having been issued in 2006 and 2009. By collecting a multitude of data points from a variety of sources, the Report Card seeks to evaluate conditions under which emergency care is being delivered, as well as the national and state policies that drive and regulate this care. It is not in any way meant to speak to the quality of care delivered by hospitals or providers. The Report Card focuses on five categories critical to the efficient delivery of emergent health care: 1) Access to Emergency Care; 2) Quality & Patient Safety; 3) Medical Liability Environment; 4) Public Health & Injury Prevention; and 5) Disaster Preparedness.
As you can tell from the grades received in these various categories, this report was not used as an opportunity to tell everyone what a wonderful job we, as a nation, are doing in the delivery of care. Rather, it is a sobering and eye-opening critical evaluation, pointing out what we’re doing well and at the same time delivering a much-needed “wake up call” to state and national policymakers. And while Ohio’s report places us 7th among the states and is an improvement compared with the 2009 grades, it’s still a “C+”, and is a strong indicator we have our work cut out for us.
*(As an aside, the F received in Disaster Preparedness was based on a miscommunication, resulting in a grade that included incomplete data. It’s estimated that if the revised survey results from Ohio were used, the Disaster Preparedness grade would be a C or C-; an improvement certainly, but still not where we want to be.)
So where do we need to focus our attention in Ohio based on this report? Despite our relatively good grade and ranking in Access to Emergency Care, I still believe this to be an area deserving of our focus, especially when we consider the lack of access to mental and behavioral health services.
Ohio’s “C-“ in Public Health & Injury Prevention is not good. A quarter of our population continues to smoke, we have an unacceptable infant mortality rate, and we’re lacking in some key traffic safety provisions (think motorcycle helmets and prohibition of handheld cellphones while driving). The liability climate has improved over the past decade, thanks to the efforts of organizations like Ohio ACEP, as well as sensible malpractice reform legislation and increased judicial restraint. But we can’t take our eye off the ball on this, lest things revert. Disaster Preparedness is not quite the disaster implied by our erroneous “F”, but still requires attention and implementation of appropriate interventions.
Please, please, please…take the time to review the Report Card, study its data points, review its recommendations. We need to know this report and advocate for improving the emergency health care system—to our friends, our colleagues, our service organizations, our pew mates, AND our legislators.
Educating the public about emergency medicine is crucial to shaping public opinion and making positive change happen. As an example, we have heard for years about how “costly” and “unnecessary” ED visits are the cause of out-of-control health costs in the US. The emergency medicine community has fought this misperception and, with the recent landmark Rand Report, “The Evolving Role of Emergency Departments in the United States,” we are beginning to make headway in the arena of public opinion, evidenced by some recent articles and editorials. This is why efforts to separate fact from fiction and educate the public about emergency medicine are important. ACEP’s EM Report Card is a powerful tool to do just that.
Oh, and go 49ers.