ER Inspector KINGS COUNTY HOSPITAL CENTERKINGS COUNTY HOSPITAL CENTER

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Updated September 19, 2019

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KINGS COUNTY HOSPITAL CENTER

451 clarkson avenue, brooklyn, N.Y. 11203

(718) 245-3901

66% of Patients Would "Definitely Recommend" this Hospital
(N.Y. Avg: 66%)

2 violations related to ER care since 2015

Hospital Type

Acute Care Hospitals

Hospital Owner

Government - Local

ER Volume

Very high (60K+ patients a year)

See this hospital's CMS profile page or inspection reports.

Patient Pathways Through This ER

After a patient arrives at the emergency room, they are typically seen by a doctor or medical practitioner and then either sent home or admitted to the hospital and taken to a room. A small percentage of patients leave without being seen. The chart below shows on average how long each of these pathways take. Lower numbers are better, and all times refer to the average length of time people waited.

Arrives at ER
5% of patients leave without being seen
12hrs 33min Admitted to hospital
17hrs 33minTaken to room
3hrs 55min Sent home

All wait times are average.

Detailed Quality Measures

Here is a more in depth look at each quality measure, compared to state and national averages for hospitals with very high ER volumes. Experts caution that very small differences between hospitals for a given measure are unlikely to correspond to noticeable differences in the real world.

Measure
Average for this Hospital
How this Hospital Compares

(to other hospitals with similar
ER volumes, when available)

Discharged Patients
Time Until Sent Home

Average time patients spent in the emergency room before being sent home (if not admitted).

3hrs 55min
National Avg.
2hrs 50min
N.Y. Avg.
3hrs 26min
This Hospital
3hrs 55min
Impatient Patients
Left Without
Being Seen

Percentage of patients who left the emergency room without being seen by a doctor or medical practitioner.

5%
Avg. U.S. Hospital
2%
Avg. N.Y. Hospital
2%
This Hospital
5%
Admitted Patients
Time Before Admission

Average time patients spent in the emergency room before being admitted to the hospital.

12hrs 33min

Data submitted were based on a sample of cases/patients.

National Avg.
5hrs 33min
N.Y. Avg.
7hrs 50min
This Hospital
12hrs 33min
Admitted Patients
Transfer Time

Among patients admitted, additional time they spent waiting before being taken to their room (sometimes referred to as "boarding time.")

5hrs

Data submitted were based on a sample of cases/patients.

National Avg.
2hrs 24min
N.Y. Avg.
3hrs 12min
This Hospital
5hrs
Special Patients
CT Scan

Percentage of patients who arrived with stroke symptoms and did not receive brain scan results within 45 mins.

No Data Available

The number of cases/patients is too few to report.

National Avg.
27%
N.Y. Avg.
26%
This Hospital
No Data Available

Violations Related to ER Care

Problems found in emergency rooms at this hospital since 2015, as identified during the investigation of a complaint. About This Data →

Violation
Full Text
EMERGENCY SERVICES POLICIES

Aug 29, 2016

. Based on document review and interview the facility failed to follow the Emergency Department Sexual Assault Policy.

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. Based on document review and interview the facility failed to follow the Emergency Department Sexual Assault Policy. This was found in 2 (two) of 2 (two) medical records reviewed. (Patients #1 and #2) Findings: Medical Record for Patient #2 revealed, on 08/20/16 at 4:30 PM, the patient reported to Emergency Department (ED) staff a sexual assault violation by a hospital worker. The Sexual Assault Assessment Forms revealed missing and incomplete documentation. Specifically, there is no documented evidence of patient signed consent, an authorization release information, there is no provider signature authenticating the document, no evidence of a physical examination by provider, no documentation indicating the date or time of sexual assault, and no location of where the sexual assault had taken place. On 8/20/16 at 9:19 PM the physician documented a disposition note from the ED and there was no documented evidence of a medical examination post sexual assault. Medical Record for Patient #1 revealed, on 08/20/16 at 5:45 PM, the patient reported to Emergency Department (ED) staff a sexual assault violation by a hospital worker. Review of the Sexual Assault Assessment Form for Patient #1 revealed the Provider recorded no documented time of sexual assault. On 8/20/16 at 9:29 PM the physician documented a disposition note from the ED and there was no documented evidence of a medical examination post sexual assault. The facility Policy titled, "Sexual Assault Procedures in Emergency Medicine" states, "This policy applies to all adult sexual assault victims to ensure that the survivor is medically treated. Obtain consent for treatment for medical exam and treatment. Forms to be completed are: signed consent, an authorization release information and medical examination (physical diagram) all Sexual Assault Assessment Forms are to be completed." This was brought to the attention of Staff I (Senior Administrative Director, Patient Care Services) on 8/29/16 at 4:25 PM who acknowledged the finding.

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EMERGENCY SERVICES POLICIES

Aug 26, 2015

Based on record review, interviews and observation, it was determined that the emergency department did not formulate and implement policies and procedures to ensure that patients who present to the Emergency Department (ED) are provided with a timely triage assessment.

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Based on record review, interviews and observation, it was determined that the emergency department did not formulate and implement policies and procedures to ensure that patients who present to the Emergency Department (ED) are provided with a timely triage assessment. Specifically, there is no guidance developed for actions to be taken for patients who are assigned to wait for complete triage after the performance of an initial visual pre-triage assessment. This finding was identified in three (3) of thirteen (13) emergency room medical records reviewed. Findings include: Review of MR#1 on 8/25/15 identified the following information: This patient arrived to the triage area of the walk- in ED on 7/21/15 at 1911 hours (7:11 PM) with the complaint of headache in the back of the head with nausea for 2 days. The patient was seen by the pre-triage nurse (RN) and the mini-registration clerk and the above complaint was recorded. Further review of the ED record revealed that the patient was called for full triage at 2129 hours (9:29 PM), 2 hours and 10 minutes after she was pre-triaged, and was marked "no answer." The second and third calls for the patient were made by emergency staff at 2311 hrs (11:11 PM) and 2327 hrs. (11:27 PM). Review of MR#3 identified that this patient who was 3 months pregnant, (MDS) dated [DATE] at 1308 hrs (1:08 PM), with complaint of abdominal pain and cramping for 3 days. Patient was called for full triage at 5:01 PM with "no answer- walk out" noted. This was 3 hours and 53 minutes after receiving "visual pre-triage." Subsequent calls for triage at 1722 (5:22 PM) and 1730 (5:30 PM) revealed "no answer-walk out" notation in the record. Review of MR#4 identified that this [AGE] year old male was "visually assessed" by the mini triage RN on 7/20/15 at 0957 ( 9:57 AM ) for complaint of abdominal pain, status post colonoscopy 2 weeks ago. At 1239 hours (12:39 PM) the patient was called for full triage with "no answer- walk out " notation. The patient was called 2 hours and 41 minutes after visual mini-triage. Subsequent calls were at 12:47 PM and again at 12:56 PM and "no answer-walk out" was recorded. During the tour of the ED on 8/24/15, the area of the ED designated for pre-triage activity was observed. The pre-triage RN was seated at a table with a registration clerk next to her in the waiting room and patients were waiting for visual pre-triage assessment and initial "mini -registration" prior to full triage. During interview with the pre-triage RN on 8/24/15 at approximately 11:00 am, the nurse stated that she records the patients' complaints and makes a quick visual assessment (mini-triage) to determine the immediacy of the patient needs. Three options are possible: she determines if the patient needs to be transported immediately into the ED to see the MD, taken for immediate full triage assessment, or whether the patient can wait in the waiting room in the order of arrival time for full triage. There was a table set up for the taking of vital signs. The RN stated that taking vital signs is optional and dependent on whether immediate vital signs needed to be taken. This interview was conducted with the ED manager present who agreed with the nurse's answers. Review of the Emergency Department (ED) Policy #38, titled,"Triage of Emergency Department Patients" effective 3/96 and revised 4/07/08 and 5/12 but not reviewed by the facility, states; "Walk in patients who present to the Emergency Department will be visually assessed by an RN who will assign priority. Then the patient will be triaged by an RN who will assign the ESI level (triage classification based upon Emergency Nurses Association (ENA) guidelines)." There was no standard as to expectations as to how long a patient can wait for triage after being "visually assessed" by the receiving RN. The patients who walked out after "visual triage" were not triaged and assigned an ESI category as stated in the policy. In addition, there were no policies and procedures to provide guidance for reassessment of patients who received "visual pre-triage assessment" but are awaiting full triage, and at what frequency this reassessment should be performed.

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Notes

“Average time” refers to the median wait time (the midpoint of all patients' wait times). References to “doctor or medical practitioner” indicate a doctor, nurse practitioner or physician's assistant. CMS reports the CT scan quality measure as the percentage of patients who received a scan within 45 minutes. We have reversed that measure so that all measures follow a “lower is better” pattern.

Additional design and development by Mike Tigas and Sisi Wei.

Sources

All data comes from the Centers for Medicare and Medicaid Services. Detailed quality measures at the hospital, state and national level were last updated September 2019. Most data was collected between October 2017 and October 2018. Data on ER-related violations is from January 2015 to June 2019.

Additional Info

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Don’t See Your ER?

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In other cases, the hospital is missing from our database because it doesn't have an emergency department.

In other cases, the hospital is missing from the federal government’s Centers for Medicare and Medicaid Services (CMS) data. There are a couple of reasons why a hospital isn’t included in CMS data: it may not participate in Medicare, or it may share a certification number with another hospital (common across large hospital systems).

If you notice a hospital missing from our database, please first check if you can find it on CMS' website, and that it is listed as having an ER. If so, please email us with the hospital name and address.