Patients at U.S. hospitals are experiencing the longest wait times in emergency departments since reports were first made available in 2002, according to Press Ganey Associates, Inc.

From the moment patients walk into a hospital ED until the time they were discharged aveaged 4 hours and 7 minutes in 2009. That's an increase of 4 minutes compared to 2008, and 31 minutes longer than the nationwide average in 2002.

The data, included in Press Ganey's "2010 Emergency Department Pulse Report: Patient Perspectives on American Health Care," is based on evaluations of more than 1.5 million patients treated at 1,893 hospitals.

In terms of wait time, Utah had the worst performance, with a staggering average ED time spent of 8 hours and 17 minutes. That's nearly 1.5 hours longer than the state's average time spent in 2008.

Iowa had the shortest average time spent at just under 3 hours (2:55), followed by South Dakota (2:59), North Dakota (3:07), Nebraska (3:08) and Minnesota (3:11). The full list of state by state average wait times is available at www.ImproveMyER.com.

Despite longer wait times, patient satisfaction with U.S. hospital ED stayed about the same in 2009, following a 5-year upward trend. More than half the states were able to improve wait times or keep increases to a minimum. Nevada made the biggest improvement in 2009, reducing average wait time by 66 minutes since 2008.

"Although the overall national average wait time increased slightly, what we found encouraging is that 32 states had either reduced wait times or held increases in wait times to 5 minutes or less over the previous year," said Deirdre Mylod, vice president, hospital services, Press Ganey. "Some states have done really well in keeping emergency department times in check, despite growing challenges of higher patient volumes and understaffing. But there's still a long way to go to make visits to the emergency department much more efficient for patients."

The Press Ganey report found communication is imperative in providing patients with satisfactory ED experiences. Patients were willing to wait for care as long as they are kept informed about wait times.

Patients who waited more than 4 hours, but received "good" or "very good" information about delays were just as satisfied as patients who spent less than 1 hour in the ED.

Improving patient flow is another way to keep patients moving efficiently through the system. A long wait time might not be indicative of the emergency department's performance. Instead, it could be a symptom of a larger hospital-wide issue that keeps the patients in the emergency department when inpatient beds or testing equipment is not readily available.

Another factor impacting patient satisfaction with emergency departments is the time of day patients arrive. According to the report, patients who arrive between 7 a.m. and 3 p.m. evaluate their care much more favorably than those who arrive after 3 p.m.