35 hour waits: now that's a real ED emergency.
Posted by CEP America on Thu, May 20, 2010 @ 08:30 AM
By Marty Ogle MD
In a recent LA TIMES article, it's reported that Los Angeles County health officials have launched an investigation into allegations that the emergency room at County-USC Medical Center is so crowded, patients wait an average of 35 hours to be seen - sometimes without any vital signs being taken. Not 3.5 hours - 35 HOURS.
A spokesman disputed the claim of 35 hour waits at the hospital's emergency room, saying the average time is less than nine hours and varies depending on the patient's illness. As if an 8 ½ hour wait in the ED is somehow acceptable.
A complaint has been filed by a patient - by coincidence, a healthcare professional - who went to the ED for abdominal pain and witnessed what she described as "an institutional disregard for basic standards of care." The list is rather long and troubling.
In one of the more obvious statements I've heard in awhile, LA County Supervisor Mark Ridley-Thomas said that "If this could be substantiated, it would be hugely problematic because it would show systemic problems."
There is no place for 35 hour waits in the ED, no matter what the excuses about facility size, number of beds or increased patient throughput.
If I could put on my County Supervisor's hat for a few moments, I would demand that performance metrics are put in place - not just at County-USC emergency department, but everywhere - to force real standards and improvement. They no longer have the excuse that their facility is old and outdated. They are no less overloaded than several surrounding busier County EDs (I happen to know, since the emergency physician partnership I'm part of manages these sites). These have average arrival to provider times of less than 30 minutes - NOT 35 hours!
Many of these surrounding County EDs I refer to are teaching hospitals, who deal with union issues, and have the same financial uncertainty that all County governments face. So, if it's not the size of the ED, and it's not the physical plant, and it's not the fact that they are a County ED, and it's not the fact that they deal with nursing and other unions, and it's not the fact that they have financial constraints, it must be, well, you get the idea. I think it's time for County-USC Medical Center to step up to the plate and acknowledge that their system is broken and do what it takes to fix it. Before you or someone you know ends up waiting 35 hours in their ED.
What are your thoughts on County-USC Medical Center's emergency department challenges? Have you had experiences with them? Please share your thoughts.