Legislation would require California hospitals to frequently assess conditions of EDs

[CAL/AAEM News Service]

Legislation would require California hospitals to frequently assess conditions of EDs

Source: The American College of Emergency Physicians ( http://www.acep.org)
Date: April 07, 2008


California's Daily Breeze (4/8, Evans) reports that State Assemblyman Ted Lieu (D-El Segundo) has introduced "Assembly Bill 2207, [which] would require hospitals to assess the condition of their" emergency departments (EDs) "every three hours, and take corrective measures immediately." Should the ED be "full, the hospital would have to move patients into other areas of its facility until conditions improve." Under the legislation, "[h]ospitals would also be allowed to move patient beds into hallways, a practice that is currently allowed only under the most extreme crowding conditions." Dr. Irv Edwards, former president of the American College of Emergency Physicians, said that EDs "have become makeshift holding wards for patients who often wait hours to be moved or treated, which further compounds crowding." 

For more information, please visit:
http://www.dailybreeze.com/ci_8846706

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Hospital crowding targeted

By Melissa Evans, Staff Writer


Source: The Daily Breeze ( http://www.dailybreeze.com )
Date: April 07, 2008


"Our need for beds exceeds our capacity," says assemblyman Ted Lieu. 

Hoping to ease emergency room crowding and improve patient safety, a local state assemblyman introduced legislation Monday that would loosen restrictions on placing hospital beds in hallways and require hospitals to formulate detailed plans to deal with all levels of crowding. 

"The emergency room is the great equalizer," said Ted Lieu, D-El Segundo, who proposed the plan on behalf of an emergency physicians group. "It doesn't matter what kind of health insurance you have, if you need treatment and you have to be rerouted to another hospital, your chances of death increase." 

Assembly Bill 2207 would require hospitals to assess the condition of their emergency rooms every three hours, and take corrective measures immediately. If the emergency room is full, the hospital would have to move patients into other areas of its facility until conditions improve. 

Hospitals would also be allowed to move patient beds into hallways, a practice that is currently allowed only under the most extreme crowding conditions, such as a natural disaster. 

These measures are needed due to the closure of dozens of trauma centers and emergency rooms throughout the region over the past two decades, said Dr. Irv Edwards, former president of the American College of Emergency Physicians, a medical advocacy group.  

"As the number of hospitals close, the number of beds gets less and less, and access to those beds gets tighter and tighter," the Manhattan Beach physician said. "Our need for beds exceeds our capacity." 

Hospital emergency rooms have become makeshift holding wards for patients who often wait hours to be moved or treated, which further compounds crowding, Edwards said. It's more dangerous to let patients leave untreated than to stack beds in hallways, he added. 

Lieu's legislation would require hospitals to file "full capacity protocols" with the Office of Statewide Health Planning and Development for each of five levels designated on a national scale that measures crowding. 

With just 6.16 emergency rooms per 1 million residents, California ranks last in the nation in providing emergency care, according to Lieu's legislation. 

The issue of crowding has become particularly acute in Los Angeles County and the South Bay, which has lost five hospitals or emergency rooms since 2004. 

In early February, state investigators threatened to issue a citation of "immediate jeopardy" at County Harbor-UCLA Medical Center near Torrance, one of the busiest hospitals in the region. Hospital officials took corrective action by bringing in more doctors. 

Dr. Lee Weiss, emergency room supervisor at Centinela Hospital Medical Center in Inglewood, said he supports the idea behind the legislation, but fears it may not solve the problem. Beds may be available in the hospital, he said, but they don't always have the staff on hand to care for patients. 

California law requires hospitals to staff one nurse for every four patients, and in some cases lower nurse-to-patient ratios are in effect, he said. Hospitals also have agreements with labor unions that have to be considered, he said. 

"It's fine to open beds up, but if you're going to staff them, it means suspending state-regulated issues," he said. "Most hospitals don't have nurses just waiting around to staff those beds." 

Lieu's legislation will likely go to the California State Assembly's Committee on Health for a first reading in the next few weeks, a staff member said. 

melissa.evans at dailybreeze.com              

For more information, please visit: 
http://www.dailybreeze.com/ci_8846706


Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

The CAL/AAEM Archives are available at: http://maillists.uci.edu/mailman/public/calaaem/


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