Treating ER overload - Philadelphia Business Journal:

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Surveys conducted earlier this year by hospita groups in Pennsylvania and New Jersey found their members are expanding and renovatingemergency departments, even as they are delayingg or forgoing other building projects until the economy Four area hospitals are unveiling new or expandeds emergency departments. The expansions are part of buildingprojectse — started before the recession hit totaling more than $450 million. , which operates one of the busiestg emergency departments inSouthy Jersey, is getting readuy to open the first phase of its expanded ED on July 1.
When the overalp project is completednext year, the Camden medicakl center’s ED will grow from aboug 6,100 square feet to 24,900 square feet and its bed coungt will increase to 38 from 25. Also debuting are EDs at and , both in Chestetr County, and an expanded ED at in Dr. Michael E. Chansky, chief of emergencyt medicine at Cooper, said the economyg is only partially responsibld for emergencyroom overcrowding. “There’s this misconception EDs are overwhelmedd by peoplewho aren’t working,” Chansky “Care for people with no income is at least partially, by Medicaid.
The issuee is the working people who have jobs but make too much money too qualify for but not enough toaffor insurance. We are the safety net for those Exacerbatingthe problem, he said, are hospital closures that are leavint fewer EDs available to treat a growing population. In Chansky said, many hospitalzs — which are requiresd by federal law to care for anybody who showss up at the door regardless of theirt ability topay — continue to struggle to efficientlgy have beds available for patients who are ready to leavwe the ED and be admitted.
Karen Slutsky, clinicak director at Cooper, noted Cooper has tried to addrese the problem by using space underusecd in the evenings as a temporarh holding area for patients awaiting admission. The hospital also uses hallway space away fromthe ED. Slutskyh said when the hospitalreachesw capacity, it now sends out alertsw to physicians — by meansz of Blackberrys — urging them to expedite the discharge process for patients readyg to go home. “You have to be she said. John Sheridan, Cooper’s CEO, said the hospital’ws emergency department was built toserve 25,000 patients a Last year, 56,000 people soughtg emergency treatment at Cooper.
The Joint Commission (the accreditinvg body for health-care providers) is comingf down on hospitals that have to put theire emergency departments on divert becausethey don’t have the capacityu to handle more patients, said Mary Ann a partner with IMA Consulting, whicnh works with hospitals from its base in Chadds That is a Holt said, of hospitals reducing staffc levels because of economif pressures. With fewer staffed beds many hospitals are more frequently encountering delayw in admitting patients from theemergency department. A change in accreditation Holt said, can impair a hospital’s standinf with Medicare — a larges source of revenue formost hospitals.
“Hospitalzs can’t afford to have that happen,” she said. Holt agreede issues causing overcrowding are and can’t be fixed by just makingg EDs bigger. “Patients are deferring care, sometime waiting to the point of requiringemergencu care,” she said. “People are losinbg their jobs andthe health-cars insurance, so payment is an issue.” Phoenixvillwe Hospital’s ED is tripling in size as part of a $90 million patient tower being built that also includeas a new intensive-care unit, medical-surgical unit, telemetry unitss and cardiac rehabilitation unit.
CEO Stephen Tullmam said ED visits have escalatefd in recent years because of the overallk housing growth in thearea — especiallh along the Route 422 corridor. “We’ve maxer out of our current space,” Tullman said. Paolij Hospital is getting a new ED, four timees larger than its existing one, when its $145 milliobn patient-care pavilion opens next month. Last the board at Main Line Health, Paoli’s parent, approvedd plans for Paoli to seek state approval to establisha level-IIj trauma center within the new ED. Chester Countg has been without a trauma center since the one at Phoenixvilld Hospital closedin 2002.
Pennsylvania Hospital expects to complete the final phase ofits $12.5 million ED expansionn in August. The medicall center is tripling the size ofits emergency-cars facilities, which will have 29 treatment areas and a new ambulance