WASHINGTON – Iowa moved from 19th place in 2009 to 11th place in the 2014 American College of Emergency Physicians' (ACEP) state-by-state report card on America's emergency care environment ("Report Card"). The state received an overall C, despite critical health care workforce shortages.
"Limited access to specialists and other health care continue to burden the Iowa health care system," said Dr. Michael Miller, president of the Iowa Chapter of ACEP. "Our state has demonstrated a great commitment to injury prevention funding and disaster preparedness. We need to build on those strengths to address remaining weaknesses in the state's support for emergency care."
Iowa received its best grade, a B for Public Health and Injury Prevention, for strong funding of injury prevention, which is reflected in the state's low fatal injury rate. Iowa has the eighth lowest rate of homicide and suicide, a very low rate of alcohol-related traffic fatalities and one of the lowest pedestrian fatality rates. The state still has one of the higher rates of fatal occupational injuries. According to the Report Card, funding directed specifically for occupational injury prevention would reduce that rate.
The C+ for Disaster Preparedness ranked Iowa 14th in the nation in this category. The state more than doubled its bed surge capacity since the last Report Card and has the fifth highest percentage of nurses who have received disaster training (47.2 percent). Iowa could improve this grade further by increasing medical professional registration in the Emergency System for Advance Registration of Volunteer Health Professionals.
Iowa received C's in both Quality and Patient Safety Environment and Medical Liability Environment, and ranked in the bottom half of the country in both categories. The state lacks specific triage and destination policies for stroke and heart attack patients and lacks a uniform system for providing pre-arrival instructions. Iowa has few legal protections in place for physicians who provide emergency care to high-risk patients. Iowa's Medical Liability Environment could be improved by the institution of pretrial screening panels to discourage frivolous lawsuits and a cap on non-economic damages.
The C- and 13th place ranking signals a decline for Iowa in the category of Access to Emergency Care from the 2009 Report Card. The state has the lowest per capita rate of emergency physicians in the nation and lacks neurosurgeons, plastic surgeons, orthopedists and hand surgeons. Increased Medicaid fee levels could help attract and retain a skilled health care workforce.
"The best medicine in the world won't help you if there's no physician to deliver it in a timely manner," said Dr. Miller. "Iowa must focus on increasing our medical workforce and enacting medical liability reforms to make Iowa an attractive place to physicians."
"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.
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"Limited access to specialists and other health care continue to burden the Iowa health care system," said Dr. Michael Miller, president of the Iowa Chapter of ACEP. "Our state has demonstrated a great commitment to injury prevention funding and disaster preparedness. We need to build on those strengths to address remaining weaknesses in the state's support for emergency care."
Iowa received its best grade, a B for Public Health and Injury Prevention, for strong funding of injury prevention, which is reflected in the state's low fatal injury rate. Iowa has the eighth lowest rate of homicide and suicide, a very low rate of alcohol-related traffic fatalities and one of the lowest pedestrian fatality rates. The state still has one of the higher rates of fatal occupational injuries. According to the Report Card, funding directed specifically for occupational injury prevention would reduce that rate.
The C+ for Disaster Preparedness ranked Iowa 14th in the nation in this category. The state more than doubled its bed surge capacity since the last Report Card and has the fifth highest percentage of nurses who have received disaster training (47.2 percent). Iowa could improve this grade further by increasing medical professional registration in the Emergency System for Advance Registration of Volunteer Health Professionals.
Iowa received C's in both Quality and Patient Safety Environment and Medical Liability Environment, and ranked in the bottom half of the country in both categories. The state lacks specific triage and destination policies for stroke and heart attack patients and lacks a uniform system for providing pre-arrival instructions. Iowa has few legal protections in place for physicians who provide emergency care to high-risk patients. Iowa's Medical Liability Environment could be improved by the institution of pretrial screening panels to discourage frivolous lawsuits and a cap on non-economic damages.
The C- and 13th place ranking signals a decline for Iowa in the category of Access to Emergency Care from the 2009 Report Card. The state has the lowest per capita rate of emergency physicians in the nation and lacks neurosurgeons, plastic surgeons, orthopedists and hand surgeons. Increased Medicaid fee levels could help attract and retain a skilled health care workforce.
"The best medicine in the world won't help you if there's no physician to deliver it in a timely manner," said Dr. Miller. "Iowa must focus on increasing our medical workforce and enacting medical liability reforms to make Iowa an attractive place to physicians."
"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.
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