Tennessee improved in Emergency Physicians’ report card

Posted on Saturday, January 18, 2014 at 8:14 pm

Tennessee climbed from 33rd in the nation in 2009 to 17th in the 2014 American College of Emergency Physicians’ state-by-state report card on America’s emergency care environment.

The state has made progress in the categories of Disaster Preparedness and Medical Liability Environment, but still faces challenges related to high rates of preventable deaths and lack of hospital capacity.

“Tennessee received a good grade in Disaster Preparedness, showing what we are capable of,” said Dr. Thomas Mitchell, president of the Tennessee College of Emergency Physicians. “However, we had a sharp decline in our Quality and Patient Safety Environment and poor grades in other categories. This shows how much work we have left to do.”

Tennessee earned a B-minus in Disaster Preparedness because of policies that included sharing all-hazards plans with all emergency medical services and essential hospital personnel. By comparison, 13 states received F’s in this category.

“Everyone hopes that their communities would perform as well as Boston did after the marathon bombing, yet nearly half the states received either D’s or F’s for disaster preparedness, which is alarming,” said Dr. Alex Rosenau, president of the American College of Emergency Physicians.

In addition, the state has a better than average bed surge capacity and ranks among the top 20 states for rates of physicians and nurses registered in the Emergency System for Advance Registration of Volunteer Health Professionals.

In the category of Medical Liability Environment, Tennessee placed a medical liability cap on non-economic damages in 2011, which helped move the state from 25th in this category in 2009 with a grade of C-minus to 11th with a grade of B.

The state declined from 13th in the nation with a B-plus to 29th with a C in the category of Quality and Patient Safety. According to the Report Card, Tennessee has not kept pace with improvements made by other states in this area. The state ranked sixth worst in the nation for lack of adoption of computerized practitioner order entry.

Tennessee fell from 21st in the nation to 26th in the category of Access to Emergency Care, for which it received a D. The per capita rate of emergency departments has fallen from 13.8 per 1 million people to 10.5, well below the national average.

Tennessee’s worst grade, a D-minus, is for Public Health and Injury Prevention for which it is ranked 37th in the nation. The state has high rates of traffic, fire and poisoning fatalities. It has the third highest infant mortality rate in the nation.

While America earned an overall mediocre grade of C-minus on the Report Card issued in 2009, this year the country received a near-failing grade of D-plus.

Rosenau said the nation’s lower grade reflects a misguided focus on cutting resources for emergency departments because of the popular but misguided view that emergency care is expensive, despite being less than 5 percent of overall health care costs.

“America’s grade for Access to Emergency Care was a near-failing D-minus because of declines in nearly every measure,” said Dr. Jon Mark Hirshon, chair of the task force that directed development of the report card. “It reflects that hospitals are not getting the necessary support in order to provide effective and efficient emergency care. There were 19 more hospital closures in 2011 and psychiatric care beds and hospital inpatient beds have fallen significantly, despite increasing demand. People are increasingly reliant on emergency care and primary care physicians are advising their patients to go to the emergency department after hours to receive complex diagnostic workups and to facilitate admissions for acutely ill patients.”

According to the report card, states continued to struggle with issues including health care workforce shortages, limited hospital capacity to meet the needs of patients, long emergency department wait times and increasing financial barriers to care.

To access the report with statistics for all 50 states and the District of Columbia, visit www.emreportcard.org.

-From Staff Reports

Headlines of the Day