Emergency Physicians Call On Policymakers and
Presidential Candidates To Strengthen the Nation's ERs as Part of
Health Care Reform
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ACEP Task Force Issues Recommendations Following release of Survey that Finds Crowding from Inpatient 'Boarding' A Top Patient-Safety Concern
Washington, DC - The nation's emergency physicians are calling on policymakers and the presidential candidates to address the escalating crisis facing emergency patients as part of their health care reform proposals, saying that safety is being compromised, and patients are dying. To raise awareness of the severity of the problem, ACEP is conducting a national public education campaign, which includes radio advertising, and nearly 400 emergency physicians are making visits in Congress this week to advocate for their patients and for passage of the Access to Emergency Medical Services Act (H.R. 882 and S.1003).
"Everyone may be an emergency patient at some point, and emergency patients are being overlooked in the health care reform debate," said American College of Emergency Physicians president Dr. Linda L. Lawrence. "ERs are a critical, often life-or-death, part of our health care system that need help now. Tens of thousands of lives are saved each year by emergency physicians, despite a broken health care system that everyone finds harder to access. The situation is worsening, and emergency patients are suffering."
The Access to Emergency Medical Services Act calls for the Centers for Medicare & Medicaid Services to collect data on emergency department boarding so that standards and guidelines can be developed. In addition, it would create a national bipartisan commission on access to emergency medical services to examine factors that affect the delivery of care in U.S. emergency departments. The bills also would provide some additional emergency care resources.
In addition, Dr. Lawrence said a new survey found that crowding from inpatient boarding is the leading safety concern among emergency physicians. Sixty-five percent of the 2,902 emergency physicians responding rated crowding as their top concern (among 16 concerns), followed by availability of on-call specialists (50 percent) and nursing shortages (39 percent).
Controversial Practice Puts Baby's Life at Risk
Dr. Lawrence said that patients across the country are struggling to get emergency care. As an example, she pointed to the experience of Mrs. Brandy Nannini of Alexandria, Va. Mrs. Nannini's baby was having a seizure and trouble breathing, and she and her husband were diverted from one hospital to another, with the ambulance barely making to the second hospital in time to save their baby's life.
Mrs. Nannini described what happened, saying, "I was begging for help, knowing that each passing minute could mean permanent brain damage for my baby. But the hospital was so full, they couldn't take any more patients. People were stacked on gurneys, lining hallways, and waiting for beds. This is crazy - people's lives are at stake."
"No one should ever go through what Brandy and her baby Bella went through, and yet this happens every day in this country," said Dr. Lawrence. "This is yet another example of how the nation's overwhelmed emergency departments and health care system are failing. That's why the nation's emergency physicians are asking the public to send messages to Congress. No patient should suffer or die because he or she can't get emergency care."
Solutions to Boarding
The nation's emergency physicians recently released a report that recommends high-impact, low-cost solutions to address the problem of holding or "boarding" patients who have been admitted to the hospital in the emergency department.
"Some hospitals are improving the flow of patients by freeing up resources in emergency departments to care for additional patients," said Dr. Lawrence. "We hope all hospitals will take steps to address the problem of boarding, because it is the primary cause of crowding."
The Boarding Task Force recommendations include:
Move admitted patients out of the emergency department to inpatient areas (see full capacity protocol www.hospitalovercrowding.com). With each unit taking a small number of patients, this will spread the burden of boarding, and the emergency department can function to care for emergencies - without unduly stressing the inpatient units.
Coordinate the discharge of hospital patients before 12 noon. Research shows that timely departure from the hospital can significantly improve the flow of patients in emergency departments by making more inpatient beds available to emergency patients
Coordinate the scheduling of elective patients and surgical cases. Studies demonstrate that the uneven influx of elective patients (heaviest early in the week) is a prime contributor to exceeding capacity.
ACEP is a national medical specialty society representing emergency medicine with more than 26,000 members. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.
