Hospitals are in a race against time.
Some are vowing to see patients within a half-hour of showing up in the emergency room.
Others are scheduling patients for doctors' appointments within three days, instead of three weeks.
And a few even offer same-day biopsies for women with abnormal mammograms.
"We're realizing that patients' time is critical and very few people have the time to spend six hours in an emergency room waiting to be seen," said Dr. Jonathan Landis, medical director of the emergency department at Canonsburg General Hospital in Washington County, where patients don't even sit in a traditional waiting room.
When they set foot in the ER there, patients immediately are taken to an examination room. The registration process takes place at the bedside. "I can sometimes see a patient before they are registered. It really speeds things up," Landis said.
If time is of the essence when it comes to medical care, it's because hospitals are realizing that timeliness often can help prevent complications, unnecessary hospitalizations and more serious outcomes.
"It's certainly only in people's best interest to be able to get care in a timely fashion," said Arthur Levin, director of the Center for Medical Consumers in New York City and a member of the Institute of Medicine's committee on quality of health care in America. "It's important that people are not falling in the cracks."
Earlier this month, Gov. Ed Rendell put the spotlight on timely access to quality health care when he unveiled his plan to overhaul the state's health care system. Among his goals is making sure residents have access to nonemergency care on evenings and weekends.
Such focus on easy access -- and time -- is already under way at some local hospitals.
At the University of Pittsburgh Medical Center, whose network has 18 hospitals in the region, administrators have made it a goal to schedule doctors' appointments within 72 hours of a patient's call.
That's true for primary care doctors as well as specialists from cardiologists to oncologists.
The reason is quality, according to Dr. Marshall Webster, president and chief executive of the University of Pittsburgh Physicians.
"If you have chest pain, it may or may not be serious," Webster said. "If it is serious, you certainly don't want to wait and risk the possibility of myocardial infarction (heart attack)."
Through a program called Access, UPMC has been able to sharply reduce the wait time for appointments in 35 specialties, thanks in part to computerized scheduling and better training of workers who set appointments, Webster said.
The wait for a cardiology appointment at UPMC has dropped from 20 to three days, and the wait for a dermatology appointment has gone from 19 to three days, said Tami Merryman, vice president of UPMC's Center for Quality Improvement and Innovation.
"If you are suspicious that you have something medically happening and you are delayed, it certainly can lead to potential complications or extended healing time, extended recovery time or possibly even needing hospitalization," Merryman said.
Magee-Womens Hospital and the Hillman Cancer Center, both part of UPMC, created a same-day service for women who receive abnormal mammogram results or whose doctors discover a breast abnormality during a physical exam. When they go for a follow-up appointment, the patients can get a biopsy done on the same day. In the past it might have taken about 10 days to get the biopsy scheduled.
In a typical week, Magee and Hillman are performing 15 biopsies on the same day, and 60 patients get other same-day services every week.
At Allegheny General Hospital's Suburban Campus in Bellevue, officials established a 30-minute pledge in the emergency department, said Dr. Fred Harchelroad, the department's medical director.
Across the nation, patients wait an average 46.5 minutes to see an emergency room physician, according to a 2005 report released by the Centers for Disease Control.
"The idea is that you will be seen by a physician within 30 minutes of walking in the door," Harchelroad said.
Patients who wait longer are given a pair of movie passes, he said. That happens about 5 percent of the time, depending on how busy the department is, he said.
Ann Smyers, of Ross, was pleasantly surprised when her 7-year-old daughter was examined by Suburban doctors within minutes of their arrival at the ER.
"We couldn't get over it," said Smyers, whose daughter, Lillia, had a broken arm. "When you're in a crisis, you don't have patience. It's a great thing they're doing."
The 30-minute pledge does not extend to other hospitals in the West Penn Allegheny network, but workers are aware they need to be more efficient, Canonsburg General's Landis said.
"There are times when you have sicker patients and you have to spend more time with them," he said. "But it's become more of a mind-set of the staff to step it up a notch and get things done a bit quicker."
Officials at UPMC said that even without offering a 30-minute pledge, some hospitals are seeing patients within that time frame.
Six UPMC hospitals -- Presbyterian in Oakland, Shadyside, South Side, Passavant in McCandless, Braddock and St. Margaret near Aspinwall -- have implemented a program called FirstNet that allows administrators to keep track of how much time it takes ER patients to get registered, be examined by a doctor and get any tests.
Though pleased with the program's results, UPMC's Merryman said she's not quite sure a patient's experience should be measured in terms of the time they spend in the hospital.
"If you focus on meeting a time, you can miss what you are looking for," she said. "We try to look at the patient's needs, as opposed to setting a target. We want to keep our eye on the ball, and the ball is the patient."
