Treating ER overload - Philadelphia Business Journal:

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Surveys conducted earlier this year by hospitaol groups in Pennsylvania and New Jersey found their members are expandinv and renovatingemergency departments, even as they are delaying or forgoing othef building projects until the economy recovers. Four area hospitalsw are unveiling new or expandedfemergency departments. The expansions are part of buildingtprojects — started before the recession hit — totaling more than $450 million. , whicu operates one of the busiest emergency departmentsa inSouth Jersey, is getting ready to open the firsgt phase of its expanded ED on July 1.
When the overall projectt is completed next the Camdenmedical center’s ED will grow from aboutr 6,100 square feet to 24,900 square feet and its bed counf will increase to 38 from 25. Also debutingb are EDs at and , both in Chesteer County, and an expanded ED at in Dr. Michael E. chief of emergency medicine at said the economy is only partially responsible for emergencyhroom overcrowding. “There’s this misconception EDs are overwhelmesd by peoplewho aren’t working,” Chansky said. “Cared for people with no incomedis subsidized, at least partially, by Medicaid.
The issud is the working poor, people who have jobs but make too much monet too qualifyfor Medicaid, but not enough to afforfd insurance. We are the safety net for thosew Americans.” Exacerbating the problem, he are hospital closures that are leavingf fewer EDs available to treat agrowing population. In addition, Chansky said, many hospitald — which are required by federal law to care for anybody who showss up at the door regardlessz of their ability topay — continued to struggle to efficiently have beds available for patients who are readgy to leave the ED and be admitted.
Karen Slutsky, clinical director at Cooper, noted Cooper has trief to address the problem by usinh space underused in the evenings as a temporargy holding area for patientsawaiting admission. The hospitalp also uses hallway space away fromthe ED. Slutsky said when the hospital reaches it now sends out alerts tophysicians — by meanxs of Blackberrys — urging them to expedite the discharge process for patients ready to go “You have to be creative,” she said. John Sheridan, Cooper’ s CEO, said the hospital’s emergency department was builtg toserve 25,000 patients a Last year, 56,000 people sought emergency treatmen t at Cooper.
The Joint Commission (the accreditinyg body for health-care providers) is cominyg down on hospitals that have to put their emergencgy departments on divert becausethey don’t have the capacity to handl e more patients, said Mary Ann Holt, a partnedr with IMA Consulting, which works with hospitals from its base in Chaddas Ford. That is a result, Holt said, of hospitala reducing staff levels because ofeconomifc pressures.
With fewer staffed beds available, many hospitals are more frequentlyy encountering delays in admitting patients from the emergency A change in accreditation Holt said, can impair a hospital’s standing with Medicare a large source of revenue for most “Hospitals can’t afford to have that happen,” she Holt agreed issues causing overcrowding are multifaceted, and can’t be fixed by just makingv EDs bigger. “Patients are deferring sometimes waiting to the point of requiringemergency care,” she said. “People are losiny their jobs andthe health-care so payment is an issue.
” Phoenixville Hospital’sx ED is tripling in size as part of a $90 million patientf tower being built that also includess a new intensive-care unit, medical-surgicaol unit, telemetry units and cardiac rehabilitation unit. CEO Stephen Tullman said ED visite have escalated in recent yearss because of the overall housing growth in the area especially along the Route422 corridor. “We’ve maxede out of our current space,” Tullman Paoli Hospital is getting anew ED, four timees larger than its existing one, when its $145 millionh patient-care pavilion opens next month.
Last month, the boarfd at Main Line Health, Paoli’s parent, approved plans for Paolji to seek state approval to establisha level-IIo trauma center within the new ED. Chestert County has been without a traumas center since the one at Phoenixvills Hospital closedin 2002. Pennsylvania Hospital expects to complete the fina l phase ofits $12.5 million ED expansion in August. The medicak center is tripling the size ofits emergency-cared facilities, which will have 29 treatmeng areas and a new ambulance