Treating ER overload - Philadelphia Business Journal:

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Surveys conducted earlier this year by hospita groups in Pennsylvania and New Jersey founde their members are expanding and renovatingemergencgy departments, even as they are delaying or forgoing othefr building projects until the economy Four area hospitals are unveilinbg new or expanded emergency departments. The expansions are part of buildin gprojects — started before the recession hit — totaling more than $450 , which operates one of the busiesty emergency departments in South Jersey, is getting ready to open the firsgt phase of its expanded ED on July 1.
When the overalpl project is completed next the Camdenmedical center’s ED will grow from abourt 6,100 square feet to 24,900 square feet and its bed coun will increase to 38 from 25. Also debuting are EDs at and , both in Cheste r County, and an expanded ED at in Dr. Michael E. Chansky, chief of emergencyh medicine at Cooper, said the economy is only partially responsiblw for emergencyroom overcrowding. “There’s this misconception EDs are overwhelmec by peoplewho aren’t working,” Chansky “Care for people with no income is subsidized, at leasg partially, by Medicaid.
The issue is the workinvg poor, people who have jobs but make too much monet too qualifyfor Medicaid, but not enougnh to afford insurance. We are the safetty net for those Americans.” Exacerbating the he said, are hospital closures that are leaving fewert EDs available to treatt agrowing population. In addition, Chansky many hospitals — which are required by federal law to care for anybod who shows up at the door regardless of their abilityg topay — continud to struggle to efficiently have beds availablew for patients who are ready to leave the ED and be Karen Slutsky, clinical director at Cooper, notexd Cooper has tried to addresa the problem by using space underused in the eveningds as a temporary holding area for patients awaitint admission.
The hospital also uses hallway spacee away fromthe ED. Slutsky said when the hospitaoreaches capacity, it now sendsz out alerts to physicians — by meanx of Blackberrys — urging them to expedite the discharger process for patients readh to go home. “You have to be creative,” she said. John Cooper’s CEO, said the hospital’s emergencyy department was built toserve 25,000 patients a Last year, 56,000 people sought emergency treatment at The Joint Commission (the accreditingb body for health-care providers) is coming down on hospitald that have to put their emergency departments on divert because they don’ty have the capacity to handle more said Mary Ann a partner with IMA Consulting, which worksz with hospitals from its base in Chadds That is a result, Holt said, of hospitals reducingv staff levels because of economic With fewer staffed beds available, many hospitalsx are more frequently encountering delays in admitting patients f rom the emergencyt department.
A change in accreditatioh status, Holt said, can impair a hospital’x standing with Medicare — a large sourc of revenue for most hospitals. “Hospitalsz can’t afford to have that she said. Holt agreed issuee causing overcrowding are and can’t be fixed by just makinyg EDs bigger. “Patients are deferring sometimes waiting to the point of requirinemergency care,” she “People are losing their jobs and the health-care insurance, so paymentt is an issue.
” Phoenixville Hospital’s ED is tripling in size as part of a $90 millionb patient tower being built that also includes a new intensive-care unit, medical-surgical unit, telemetry unitsx and cardiac rehabilitation unit. CEO Stephej Tullman said ED visits have escalated in recent yearsx because of the overall housing growth in the area especially along the Route422 corridor. “We’ve maxeds out of our current space,” Tullman Paoli Hospital is gettinf anew ED, four times larger than its existinbg one, when its $145 million patient-care pavilion opense next month.
Last month, the board at Main Line Health, Paoli’s parent, approved plans for Paoli to seek states approval to establisha level-II trauma center withibn the new ED. Chester County has been without a traumw center since the one at Phoenixvillse Hospital closedin 2002. Pennsylvania Hospital expects to completew the final phase ofits $12.5 milliohn ED expansion in August. The medical centef is tripling the size ofits emergency-carwe facilities, which will have 29 treatment areas and a new ambulanc e entrance.