Tennessee Improves Rankings, Receives C- for its Policies that Support Emergency Patients

Jan 16, 2014, 11:00 ET from American College of Emergency Physicians (ACEP)

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WASHINGTON, Jan. 16, 2014 /PRNewswire-USNewswire/ -- 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 ("Report Card"). 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.

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"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- in Disaster Preparedness because of policies that included sharing all-hazards plans with all emergency medical services and essential hospital personnel. 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. According to the Report Card, the grade would further improve with an increase in federal disaster preparedness funds, which have declined since 2009.

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- to 11th with a grade of B.

The state declined from 13th in the nation with a B+ 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 6th worst in the nation for lack of adoption of computerized practitioner order entry. Tennessee could improve this grade by encouraging hospitals to adopt technological advances at a faster pace. It should also implement a uniform system for providing pre-arrival instructions for stroke and heart attack patients.

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. The pool of psychiatric and staffed inpatient beds has also fallen, mostly like because of the closure of two hospitals in 2011. To improve this grade, Tennessee must monitor ambulance diversion and emergency department wait times to minimize their impact of patient care. It should further act to ensure that all patients are able to afford needed preventive and emergency health care, since it reports the highest proportion of adults with insurance who report cost as a barrier to receiving medical care.

Tennessee's worst grade, a D-, 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 3rd highest infant mortality rate in the nation. To improve this grade, the state must explore the underlying causes of these deaths and implement outreach and evidence-based education efforts.

"Emergency physicians save one life at a time, while investment in injury prevention and public health can save thousands" said Dr. Mitchell.

"America's Emergency Care Environment:  A State-by-State Report Card – 2014" evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. It has 136 measures in five categories:  access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

Follow ACEP on Twitter @emergencydocs

SOURCE American College of Emergency Physicians (ACEP)