Actors Noah Wyle and Shawn Hatosy in The Pitt’s first season. (Photo by Warrick Page/Max)
The hospital that inspired the medical drama has the longest wait times in the city, though long visits are common across the major health systems. AGH and UPMC both have major revamps underway that could ease wait times.
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Allegheny General Hospital’s emergency department — known as the real-life inspiration for HBO’s acclaimed drama “The Pitt” — has the longest average patient visit time in Pittsburgh at four hours. With a $43 million renovation underway, hospital leaders aim to change that.
The hospital announced plans for a comprehensive emergency room renovation in May, just weeks after the season finale of “The Pitt.”
The show’s realism has drawn praise from health care professionals, echoing real challenges facing ERs — long wait times, staffing shortages, safety concerns — that hospitals like AGH are now working to address.
While the indoor shots of the show were filmed on a 22,000-foot set in California, the outdoor shots for “The Pitt” were filmed on-site in Pittsburgh.
Production designer Nina Ruscio was tasked with the question: “How do I make this emergency department feel as if it is in Pittsburgh?”
A central part of the show focuses on the ER waiting room. The arms of the chairs are carved into and covered in tape and stains. Ruscio wanted the room to have a sense of anxiety about it, just like in reality.
“It has a gravitas to it that gives the show a sense of place.”
Dr. Brent Rau, the medical director in the department of emergency medicine at the AGH, noticed the show’s realism.
“It did a very good job of showing not only the challenges of the prolonged wait times, but the things we have to do to function and to provide best care for our patients,” he said.
Doctors and hospital administrators point to a host of factors: staffing shortages, pay gaps, run down facilities, and more, that contribute to the delays.
Sitting, waiting, wishing … and more waiting
According to Medicare data, the median time patients spent in emergency departments in Pittsburgh ranges from 144 minutes at the VA Medical Center in Oakland to 244 minutes — a little over four hours — at AGH.
Median time patients spent in the emergency room
| Allegheny General Hospital | 40,000 – 59,999 | 244 |
|---|---|---|
| UPMC East | 20,000 – 39,999 | 242 |
| UPMC Presbyterian | 60,000+ | 234 |
| Forbes Hospital | 40,000 – 59,999 | 232 |
| UPMC St. Margaret | 20,000 – 39,999 | 230 |
| UPMC Mercy | 40,000 – 59,999 | 215 |
| UPMC Magee-Womens Hospital | 20,000 – 39,999 | 206 |
| UPMC McKeesport | 20,000 – 39,99 | 202 |
| UPMC Passavant | 40,000 – 59,999 | 195 |
| St. Clair Hospital | 40,000 – 59,999 | 183 |
| Jefferson Hospital | 40,000 – 59,999 | 178 |
| West Penn Hospital | 20,000 – 39,999 | 176 |
| VA Pittsburgh Healthcare System | 0 – 19,999 | 144 |
The national average (mean) for time spent in the emergency room is 162 minutes, according to the U.S. Centers for Medicare & Medicaid Services as of April, 2025. In Pennsylvania, the mean value is not made public, but the median (the middle number within the range of wait times) is 183 minutes.
Major revamp should ease waits
Rau said renovation at AGH has been a long time coming.
“We’ve needed it for quite a while, just considering our volume in the acuity of patients that we see in the emergency department, we’ve needed [a department] that is large enough, not only to handle the volume of patients that we see but also the complexity of patients that we see,” Rau said.
According to Rau, the ER sees around 45,000 patients annually, with the highest volumes in the summer. The $43 million renovation aims to increase and upgrade rooms, beds and facilities, along with increasing staff.
“We have a pretty good idea of what is needed, but we’re also really ready to adapt. If we realize after a section of the ED opens — if we feel like we need more additional staffing, we certainly are willing to do that to make sure our patients receive as close to one-on-one care as possible,” Rau said.
The overcrowding in emergency rooms means some patients are seen in hallways at AGH and other hospitals in the area, said Rau, who hopes the renovation will relieve the issue.
“We want to get patients out of the hallways and into actual private rooms too so that we can deliver care that our patients deserve, and I think that is one of the big things that we’re hoping to gain by increasing our space considerably.”
The first phase of a five-step renovation process is underway. During construction, AGH’s emergency department is using other sections of the hospital to increase the number of available beds in the meantime.
On-screen violence is all too real
“The Pitt” also portrays the real-life security challenges that emergency rooms face.
The renovation also aims to improve security for the hospital workers, by adding more centralized police as well as new forms of security alarms. Rau said the portrayal of violence in “The Pitt” was one that he was all too familiar with.
“They clearly had done their homework.”
In 2024 the ACEP reported that 91% of emergency physicians said that they, or a colleague, were a victim of violence in the past year.
Rau mentioned that violence is a very real issue that affects health care workers, especially those who work in larger sites. The renovation team had this in mind when crafting a new layout that optimized security and efficiency.
Portraying the unknown hardships health care workers go through was a necessity for cinematographer Johanna Coelho.
“It’s a very important show, it’s showing the truth about the health care system, and health care workers… It’s shocking. I feel like a lot of people don’t know what’s really happening or what their life is like.”
Rau said most doctors or nurses at AGH who have worked at the hospital for several years have experienced violence in the workplace. The incidents take many forms and cannot be attributed to a certain group of people or circumstances, Rau said.
Scenes from the first season of “The Pitt.” (Photos by Warrick Page/Max)
For AGH, safety of staff and patients is the main priority. They want to get the number of incidents as close to zero as possible.
“Violence in the workplace — unfortunately, it’s a very real thing that ERs deal with, especially the larger sites. It is a very real thing that we certainly deal with at Allegheny General.”
Long visits plague the region
While AGH has the longest wait time in the Pittsburgh region, it’s not the only hospital where people experience lengthy ER visits.
The average wait time for the more than 60,000 patients who seek emergency care at UPMC Presbyterian (often referred to as Presby) in Shadyside is 3 hours and 54 minutes, the second highest in Pittsburgh.
UPMC Presby is midway through a $1.5 billion project of its own to construct a 17-story building, which will include a new emergency room with additional beds. The building will be equipped with over 600 private rooms, as well as facilities for its neurological, transplant and cardiology units.
UPMC did not respond to questions sent by PublicSource.
Madelaine Hinkle is an incoming ER Nurse at UPMC Presby. Previously, she worked as a patient care technician at the same hospital.
Hinkle loves the fast-paced environment of an emergency room, but isn’t shy about voicing the challenges — one of which is the nurse shortage. She said she believes this is a trickle-down problem, stemming from hospitals having a limited number of open nursing positions.
As depicted in “The Pitt,” there are many factors contributing to the lack of beds available. For Hinkle, the main issue is a shortage of staff. Hinkle mentioned how the shortages are not occurring due to a lack of people willing to work but rather, how much pay is allocated for ER nurses.
“We need more beds, but even when we have the beds, we don’t have the nurses … You can’t put someone in a room without a nurse,” Hinkle said.
Hinkle said she sees around four to eight patients on average during a shift, but “nothing is for sure in the ER.” Wait times during the winter, when many people are looking for shelter, differ from those in the summer, when trauma-related injuries spike. Communication among different departments can also play a role in lengthier wait times, Hinkle said.
The long wait times are not a reflection of staff priorities, Rau said. “What we want people to understand is that we want to see you. When you show up to receive care, we want to provide you care — it’s not that we are trying to intentionally ignore you.”
Ayla Saeed is an editorial intern at PublicSource and can be reached at ayla@publicsource.org.
This article first appeared on PublicSource and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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