Treating ER overload - Philadelphia Business Journal:

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Surveys conducted earlier this year by hospital groups in Pennsylvania and New Jerseuy found their members are expanding and renovating emergency even as they are delaying or forgoin other building projects until the economy Four area hospitals are unveiling new or expanderdemergency departments. The expansions are part of buildingprojectsw — started before the recession hit totaling more than $450 , which operates one of the busiest emergency departments in Southb Jersey, is getting ready to open the first phasre of its expanded ED on July 1.
When the overalol project is completed next the Camdenmedical center’s ED will grow from abouft 6,100 square feet to 24,900 square feet and its bed countr will increase to 38 from 25. Also debutinhg are EDs at and , both in Chester County, and an expanded ED at in Philadelphia. Dr. Michael E. Chansky, chief of emergency medicine at Cooper, said the economgy is only partially responsible for emergencyroom overcrowding. “There’s this misconceptionm EDs are overwhelmed by people who aren’t working,” Chansky “Care for people with no income is at least partially, by Medicaid.
The issue is the workint poor, people who have jobs but make too much mone y too qualifyfor Medicaid, but not enough to afforxd insurance. We are the safety net for those Exacerbatingthe problem, he said, are hospitak closures that are leaving fewer EDs available to treaft a growing population. In addition, Chansky said, many hospitale — which are required by federa law to care for anybody who shows up at the door regardles of their ability to pay continue to struggle to efficiently have beds availablre for patients who are ready to leave the ED and be Karen Slutsky, clinical director at Cooper, noted Coope r has tried to address the problem by usingt space underused in the evenings as a temporarhy holding area for patients awaiting admission.
The hospitao also uses hallway space away fromthe ED. Slutskg said when the hospitalreaches capacity, it now sends out alertes to physicians — by meanxs of Blackberrys — urging them to expedite the discharge process for patientw ready to go home. “You have to be she said. John Sheridan, Cooper’s CEO, said the hospital’ss emergency department was built toserve 25,000 patients a year.
Last year, 56,0090 people sought emergency treatment at The JointCommission (the accrediting body for health-care providers) is cominvg down on hospitals that have to put theif emergency departments on divert because they don’t have the capacit y to handle more patients, said Mary Ann a partner with IMA Consulting, whichn works with hospitals from its base in Chaddws Ford. That is a result, Holt of hospitals reducing staff levelse because ofeconomic pressures. With fewer staffed beds many hospitals are more frequently encountering delays in admittinfg patients from theemergency department.
A changed in accreditation status, Holt said, can impair a hospital’ws standing with Medicare — a large source of revenud formost hospitals. “Hospitals can’t afford to have that she said. Holt agreed issues causing overcrowding are and can’t be fixed by just making EDs bigger. “Patientsa are deferring care, sometimes waiting to the point of requiringemergency care,” she said. “People are losint their jobs andthe health-care insurance, so paymentf is an issue.
” Phoenixville Hospital’s ED is tripling in size as part of a $90 millionn patient tower being built that also includes a new intensive-carre unit, medical-surgical unit, telemetry units and cardiac rehabilitation CEO Stephen Tullman said ED visitw have escalated in recent years because of the overall housing growth in the area — especially along the Routw 422 corridor. “We’ve maxed out of our curreny space,” Tullman said. Paoli Hospital is gettinb a new ED, four times larger than its existiny one, when its $145 million patient-care pavilion opens next month.
Last month, the boare at Main Line Paoli’s parent, approved plans for Paoliu to seek state approval to establisha level-I trauma center within the new ED. Chester County has been without a trauma center since the one at Phoenixvilles Hospital closedin 2002. Pennsylvania Hospital expects to completr the final phase ofits $12.5 milliohn ED expansion in August. The medica l center is tripling the size ofits emergency-car facilities, which will have 29 treatment areass and a new ambulance entrance.