More than one-third of hospitals now pay for some physician specialty emergency department call coverage, according to results from AHA’s survey  of hospital leaders. The 2007 State of America’s Hospitals – Taking the Pulse also found 55% of hospitals experienced gaps in physician specialty coverage with coverage issues most prevalent in orthopedics and neurosurgery.  In addition, nearly half of EDs are “at” or “over” capacity, with a majority of urban hospitals experiencing time on diversion. Hospital leaders cited a lack of staffed critical care beds as the most common reason for diversion. The survey also found that hospital workforce shortages, including an estimated 116,000 registered nurse vacancies as of December 2006, are affecting patient care. Regarding disaster readiness, hospitals are taking a variety of actions to bolster preparedness, including participating in large scale drills, establishing back-up communication plans and developing resource plans with other hospitals. The survey, which had a 17% response rate, was sent to about 5,000 community hospital CEOs in late February 2007 via fax and email.