A while back, I put together a small, simple site that aggregates ER wait times published by hospitals but also makes it possible for people to report their times for any hospital / urgent care.

I’ve been adding hospitals gradually and am up to ~60 or so. There’s a list on the site of all known facilities that publish times online. If I’m missing any, please send me a note.

Most of all, I’d be interested to hear your thoughts about whether or not this has any potential public utility.

Thanks again for the thoughtful and informative post.
David

The principle is a powered IV that is programmed by the anesthesiologist to allow measured boluses of the painkiller to be delivered into the IV line each time the patient presses a button. The bolus can only be delivered after a specified lapse from the previous dose (say, 8 minutes minimum), and there is a maximum combined dose per hour (say, 4 boluses max).

What was interesting was seeing how the patient reacted to the IV PCA, how he responded both to the sense of control (the button) and the sense of “out-of-control” (repeated button pressing because he didn’t know when the press would actually deliver medicine). Also interesting was how his behavior changed once he was given the information as to when the next bolus was available.

Also odd were the reactions of the pain nurse and doctor, who admitted that they intentionally do not provide guidance in device use, because they want to review the device reports (how many presses, how often) to use as a gauge of pain level over time “in case the patient can’t tell us”. [It was pointed out that the device includes a display that indicates time remaining until next dose available. The nurse countered that “it isn’t intended for the patient to see.”]

Another stated reason was that if the patient understands about the timed doses, he will watch the clock constantly (therefore not resting) and push the button whether he needs the pain control or not (and then “overdose” ” the doctor’s word). [It was pointed out to the doctor ”!” that the IV PCA system requires the *doctor* to program in both the size of the boluses and the hourly maximum delivery, so it is under the MD’s control.]

I wonder if the pacing lessons learned in queueing theory could be applied to improving pain control?

Example, for a cut hand, nurse applies dressing within 10-15 minutes, recommends and administers tetanus shot. 5 minutes later, led to a treatment room. In the next 15 minutes, doc comes in room, assesses damage, and determines stitches are the solution. No tendon damage, serious contamination risk, infection. Long wait for person qualified to put in stitches to appear. Total time, pretty long.

I’ve also gone there for back pain, with long waits in treatment room for doc, long wait to get an x-ray, long wait for doc to come back to treatment room to see x-ray. Result: no idea what’s causing the pain. Suggestion I see my rheumatologist to see if she wants to do an MRI. Three or four hours consumed.