Ophthalmology Outcomes
Emergency Department
The Emergency Department at Mass Eye and Ear provides 24/7 urgent ophthalmic care for the local community and for patients who are referred to Mass Eye and Ear from throughout the region. The department works closely with Mass General Hospital's Emergency Department to co-manage and coordinate care for patients with ophthalmic problems.
Learn more about the Emergency DepartmentAverage Monthly Ophthalmology Emergency Visits by Year
This bar graph shows the average number of ophthalmology initial encounters seen monthly by the Mass Eye and Ear Emergency Department across the last 10 calendar years.
There was a significant decrease in volume due to the Covid-19 pandemic.1
Ophthalmology Visit Times
*For calendar year 2016, the graphed data depicts only initial encounters. All other calendar years included all ophthalmic emergency visits (initial and follow-up visits).
The average ophthalmology visit time in the Mass Eye and Ear Emergency Department for calendar year 2022 was 3.5 hours. The visit time is defined as the total time from when the patient walked into the Mass Eye and Ear Emergency Department to when the patient left the Emergency Department. Visit times over three standard deviations from the raw mean were considered outliers and were excluded from the final analysis due to suspicion of poor documentation in those cases. According to the 2010 Press Ganey Emergency Department Pulse Report, patients across the United States spent an average of four hours and seven minutes (4.12 hours) per emergency department visit. The Massachusetts state average visit time was 4.06 hours.
For the past 10 years, the average ophthalmology visit time in the Mass Eye and Ear Emergency Department was lower than the average national and state visit times.
Ophthalmology “Left Without Being Seen” (LWBS) Rate
*Data reported for calendar year 2016 depicted only initial encounters. All other calendar years included all ophthalmic emergency visits (initial and follow-up visits).
“Left without being seen” (LWBS) refers to patients who present to an emergency department but leave before being seen by a physician. The Mass Eye and Ear Emergency Department reported a LWBS rate of 1.2% (249 patients for all 20,967 initial and follow-up ophthalmic emergency encounters) in calendar year 2022. According to the Agency for Healthcare Research and Quality, the national LWBS rate was 2.0% in 2018.1 LWBS rates vary greatly between hospitals; a review of the literature suggests a national range of 1.7% to 4.4%.1-5
The Mass Eye and Ear Emergency Department has a lower LWBS rate compared to national benchmarks.
Distribution of Top-20 Urgent Ophthalmology Diagnoses
During calendar year 2022, there were 18,599 ophthalmic emergency initial encounters to the Mass Eye and Ear Emergency Department. The top-20 urgent diagnoses represented 5,190 (28.0%) of the total Emergency Department initial encounters and are depicted above and ranked according to their frequency.
The top-five most frequent urgent diagnoses included retinal detachment, corneal ulcer, corneal foreign body, iridocyclitis, and keratitis.
The Emergency Department bounce back rate in calendar year 2022 was 13.0%. This rate serves as an approximation of the rate at which patients come back to the ED within one week of initial exam.* This includes scheduled and unscheduled return visits.
*This is calculated as the number of ED follow-up visits (n = 2,368) divided by the number of initial visits (n = 18,599). Visits are generally designated as follow-up if they occur within one week of a prior visit. Of note, given limits of a calendar year, not all numerator patients may be included in the denominator.
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Average Monthly Ophthalmology Emergency Visits by Year
1.Moon JY, Miller JB, Katz R, Ta T, Szypko C, Garg I, Lorch AC, Gardiner MF, Armstrong GW. The Impact of the COVID-19 Pandemic on Ophthalmic Care at an Eye-Specific Emergency Department in an Outbreak Hotspot. Clin Ophthalmol. 2020 Dec 1;14:4155-4163.
Ophthalmology “Left Without Being Seen” (LWBS) Rate
1.Agency for Healthcare Research and Quality. Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals. 2018.
2. Pham JC, Ho GK, Hill PM, et al. National study of patient, visit and hospital characteristics associated with leaving an emergency department without being seen: predicting LWBS. Acad Emerg Med 2009; 16(10): 949–955.
3. Hsia RY, Asch SM, Weiss RE, et al. Hospital determinants of emergency department left without being seen rates. Ann Emerg Med 2011; 58(1): 24-32.e3.
4. Handel DA, Fu R, Daya M, et al. The use of scripting at triage and its impact on elopements. Acad Emerg Med 2010; 17(5): 495-500.
5. Li DR, Brennan JJ, Kreshak AA, et al. Patients who leave the emergency department without being seen and their follow-up behavior: a retrospective descriptive analysis. J Emerg Med 2019; 57(1): 106-113.
