Friday, December 07, 2007

Dying To Get In......the Emergency Department

Christopher Jones, 33 years old
Edith Rodriguez, 43 years old
Brenda Vance, 49 years old

The list of patients who have died in emergency department waiting rooms while waiting to be seen could be much longer. These three names are the ones that have made the news. These three people died while waiting to get inside an emergency room to see a doctor.

The public is outraged and upset that these deaths occurred. As I read the news stories and the blogs, I see the finger of blame pointed at a nurse or a doctor or both, who failed to do something that should have been done. What I don’t see is the public outrage that our healthcare system has failed the people it should protect.

Long waiting times are not isolated to three hospitals in America. Every day in hospitals all across the country, dedicated emergency physicians and emergency nurses work long hard hours to provide care to the sick and injured. There are approximately 4600 emergency departments in America treating about 115 million people every year. That’s an average of 25,000 people per emergency department. Now, realize that some departments see many more patients, and some see fewer. However, if the average is 25,000 patients per year, that’s about 68 patients per department per day. If all 68 patients were averaged over the day, that would be 2.8 patients per hour.

Since the average emergency physician in ideal circumstances (enough nurses, enough hospital beds, enough specialists on call) can see 2.5 patients per hour, which leaves 7.2 patients every day who cannot be accommodated by the system. Added over the year, that is 2628 patients who cannot be seen by the current emergency healthcare system. These are 2628 PEOPLE who will not receive care for their illness or injury. It is easy to see why people sometimes have serious problems in the waiting room, and that the system is already full to capacity.

The calculations above are very simplistic and don’t reflect the reality of patient flow in real emergency departments, but trust me, the reality is NOT BETTER than the scenario I’ve developed above. Something must be done to increase the resources of emergency departments – nurses, on-call physicians, available hospital beds – before the stories of people like Christopher Jones, Edith Rodriguez, and Brenda Vance become the norm and not the exception.

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