What is the average wait time at a hospital?

Hospital Wait Times: Current Evidence and Clinical Implications

Average hospital wait times vary significantly by setting and patient acuity, with emergency department patients waiting a median of 38-56 minutes to see a physician, though 42% wait longer than 60 minutes, and these delays directly impact patient mortality, safety, and quality of care. 1

Emergency Department Wait Times

Documented Wait Time Benchmarks

• Median wait time to physician contact: 38 minutes (mean 56 minutes) in California EDs, with substantial variation across facilities 1
• Performance on triage targets: In the median U.S. ED, only 78% of all patients and 67% of urgent patients (triaged to be seen within 1 hour) actually receive physician contact within their target triage time 2
• Minority achievement of standards: Only 31% of EDs achieve triage targets for more than 90% of their patients, and just 14% meet targets for 90% or more of urgent patients 2

Impact of Crowding on Wait Times

ED crowding substantially increases wait times, with high-acuity patients experiencing 3-35% longer waits during crowded periods compared to normal census levels. 3

• During periods of 90% higher than average census, even the most urgent patients (Emergency Severity Index level 2) experience significantly prolonged waiting room times 3
• The percentage of patients seen within recommended triage times has been steadily declining and is at its lowest point in at least 10 years 3

Factors Associated with Prolonged Wait Times

Socioeconomic Disparities

• Income-based disparities: For every $10,000 decline in per capita neighborhood income, patients wait an additional 10.1 minutes (95% CI: 1.8-18.4 minutes) after adjusting for hospital characteristics 1
• Racial disparities: Black patients experience significantly longer mean ED wait times than white patients (69.2 vs 53.3 minutes), with disparities most pronounced in less urgent cases (up to 29.9% longer for lowest acuity) 4

Hospital Capacity and Flow Issues

Inpatient bed occupancy demonstrates a non-linear relationship with ED wait times, with a critical tipping point at high occupancy levels. 5

• At 100% bed occupancy, the proportion of patients waiting more than 4 hours increases by 9 percentage points (95% CI: 7.5-11.1%) compared to 85% occupancy 5
• Each percentage point increase in emergency admissions correlates with 0.08% more patients waiting over 4 hours (95% CI: 0.06-0.10%) 5
• Higher proportions of inpatients with hospital length of stay over 21 days correlate with 0.07% more ED patients waiting over 4 hours per percentage point increase (95% CI: 0.008-0.13%) 5

Staffing and Operational Factors

• Staffing ratios: Lower ratios of physicians and triage nurses to waiting room patients are associated with longer wait times 1
• Day of week effects: Patients visiting on Mondays are 2.64 times more likely to experience longer waiting times compared to Friday visits (AOR: 2.64; 95% CI: 1.45-4.79) 6
• Time of arrival: Patients arriving early in the morning are 3.22 times more likely to spend longer waiting time than afternoon arrivals (AOR: 3.22; 95% CI: 1.32-7.86) 6

Clinical Consequences of Prolonged Wait Times

Mortality and Safety Outcomes

ED crowding and prolonged wait times are directly associated with increased patient mortality, medical errors, and adverse events. 3

• ED crowding contributed to an estimated 300 additional inpatient deaths, 6,200 excess hospital days, and $17 million in costs in California hospitals 3
• Preventable medical errors and medication errors increase during crowded periods 3

Quality of Care Deficits

• Timeliness of treatment: Patients are 52-74% less likely to receive timely care when crowding measures are at the 75th versus 25th percentile 3
• Effectiveness of care: Patients are 9-14% less likely to receive effective care during high crowding periods 3
• Specific treatment delays: Crowding causes delays in analgesic administration for sickle cell pain crisis and antibiotic administration for community-acquired pneumonia 3

Patient Flow Disruptions

• Boarding time impact: In urban children's hospitals, boarding time and ED daily census independently associate with increased overall length of stay, time to triage, time until physician contact, and patient elopements 3
• Admission delays: Only 48% of EDs admit more than 90% of their patients within 6 hours, and just 25% achieve this within 4 hours 2

Inpatient and Transfer Wait Times

Intra-Hospital Transport

• Transfer organization delays: 38% of transfers from ED to ICU take over 20 minutes to organize, and 14% take over an hour 3
• Bed availability: In almost one-third of cases, delays are caused by shortage of available beds 3

Hospital Length of Stay

Enhanced recovery protocols can reduce hospital length of stay by an average of 1.88 days (95% CI: 0.95-2.81 days) compared to standard care. 3

Common Pitfalls and Caveats

• Wait time disparities persist across racial/ethnic backgrounds and payer types, indicating systemic rather than individual-level issues 3
• The emergency context does not always correlate with increased adverse events when adequate training and equipment are provided 3
• Critically ill patients do not experience racial disparities in wait times, suggesting triage systems appropriately prioritize the most urgent cases 4
• Communication between units is vital for reducing waiting time and transport time, particularly for diagnostic testing 3