Everett hospital hopes new system reduces ER waits
Published 11:14 pm Monday, March 23, 2009
It’s not just heart attacks and trauma patients that jam up area hospitals, causing long waits in emergency rooms and patients to be transferred to other hospitals.
Last year, winter viruses had hospitals in Snohomish County and up and down the I-5 corridor maxed out.
Two Everett patients were transported to Overlake Hospital Medical Center in Bellevue for treatment. A British Columbia hospital called Everett looking for a bed for a critical care patient because there was no available space at any hospital in the province.
And the mother of a 12-year-old Everett boy recounted how her son was initially treated in an Everett emergency room but needed to be transferred. Seattle Children’s Hospital was full. He ended up waiting six hours for an available bed to open up at another Seattle hospital.
Providence Regional Medical Center Everett has just launched a new system to help ease emergency room logjams, reducing patient wait times and transfers.
Its goal is to cut the amount of time its emergency room is on “diversion” — closed to all but the most critically ill or injured patients, with less critical patients transported to other area hospitals.
To alleviate these problems, key hospital employees are paged for a quick huddle. They identify what’s causing the problem and dispatch resources “that will free up the flow in the emergency department,” said Sharon White, nurse manager of the hospital’s emergency department.
“Maybe I have a cardiac patient I need to get admitted and they don’t have any clean beds,” White said. “It could be something as simple as that — reassigning staff within the hospital” to clean a room.
That allows patients temporarily “on hold” in the emergency room to be admitted to the hospital. That frees up extra space in the emergency room so more patients can be treated.
“Right now, we’re on diversion about two hours each day — 10 percent of the time,” White said.
The goal is to reduce by half the amount of time the emergency room is on diversion this year, she said. In the future, they hope to eliminate diversions altogether, she said.
Overcrowded emergency rooms are a problem that has worsened in recent years at hospitals across the nation, said Dr. Enrique Enguidanos, medical director of Providence’s emergency room.
In Everett, part of the problem is caused by an increase in demand for medical services. Last year, the hospital treated 105,606 emergency room patients — 10,000 more than the number it treated five years ago.
This year, demand is expected to climb ever higher at hospitals locally and across the state as unemployment rises and people lose their health insurance. Since the Everett hospital doesn’t have any room to expand until its new hospital tower opens in 2011, the attitude was: “Let’s see what we can do,” Enguidanos said.
Since the Everett hospital has 67 percent of the emergency room beds in the county, when it goes on diversion “it makes a big ripple effect in surrounding hospitals,” said Dr. Ron Brown, who is both an emergency room physician and medical program director of Snohomish County’s emergency medical service.
For example, if Everett has to transfer a patient to an out-of-town hospital, “then you’ve got two paramedic units in the city of Everett instead of three,” he said.
The city can ill afford to lose a paramedic unit for two hours to go to hospitals in Edmonds, Monroe or sometimes even Seattle, he said.
“The flip side is, if you try to tough it out and hold off on diversion, you can keep sticking patients in nooks and crannies,” Brown said. “It slows everything up.
“At Providence, I’ve been there when 10, 12 ambulances show up in a hour,” he said. “You may run out of beds to put them in.”
Based on the experience of Stevens Hospital in Edmonds, which had previously adopted a similar program, “we’re quite excited,” Enguidanos said.
“We hope this is a tool that will bring a lot of benefit to the community.”
Reporter Sharon Salyer: 425-339-3486, salyer@heraldnet.com.
