Emergency rooms bulge under patient onslaught
1/7/2004“This is a very sick city right now,” said Marja Dooner, director of emergency and trauma services at Toledo Hospital.
The emergency department closings are referred to as “bypass,” meaning ambulance patients are diverted to other hospitals. Walk-in patients, including those who are taken to hospitals by private vehicles, are allowed in bypass periods.
Toledo Hospital's emergency department went on bypass 10 times in December compared to just once the previous December and four times in December, 2001. And so far January is proving to be just as busy, Ms. Dooner added. Other hospitals in metro Toledo, as well as northwest Ohio and southeast Michigan, report they have also been swamped with patients.
Medical College of Ohio Hospital's emergency department was two patients shy of its busiest month ever in December. Flower Hospital in Sylvania went on bypass 10 times last month; it never did in December, 2002.
Fostoria Community Hospital's emergency department had its busiest month ever last month. Hospitals in Bowling Green, Defiance, and Monroe said they were close to record months in December and continue to be busy.
“We've had days when we've been bursting at the seams,” said Karen Lemerand, spokesman for Mercy Memorial Hospital in Monroe.
Hospitals nationwide are experiencing the same surge in emergency department volume as federal officials warn that the flu season has yet to reach its peak.
“Influenzalike illnesses are still on the rise,” said Dr. Scott Harber, a Centers for Disease Control and Prevention flu expert.
In addition to emergency departments, more people are visiting the doctor for flulike illnesses. About 9.4 percent of all outpatient visits surveyed by the CDC last week involved flulike illnesses, up from 7.7 percent in the previous week and the highest rate so far this season. In addition, pneumonia and influenza accounted for a season-high 9 percent of deaths, up from 7.8 percent the previous week, in a survey of 122 U.S. cities.
The spike in flu and other illnesses has come at an inopportune time for Mercy Health Partners. In August, Mercy promised that patients who go to emergency departments at its St. Charles Mercy Hospital in Oregon and St. Anne Mercy Hospital in West Toledo would be seen by a doctor in 30 minutes or less.
If not, patients are offered a choice of a $15 Speedway gas card, a $15 gift certificate to The Andersons, or a $15 donation in their name to the American Heart Association, American Cancer Society, or Children's Miracle Network.
Then the flu hit, and as a result St. Vincent Mercy Medical Center, St. Charles, and St. Anne all had record Decembers in their emergency departments.
“People just seemed to be pouring in the front door,” said Dayle Pugh, nursing director at the St. Charles emergency department.
Ms. Pugh said the heavy volume last month “obviously” had an effect on how successful her hospital was in meeting the 30-minute promise. But Mercy officials refused to say how many gift certificates or donations to charity they have had to make because of not meeting that vow. Mercy is still evaluating whether to expand the 30-minute guarantee to its busiest and largest hospital, St. Vincent.
Hospitals do not go on bypass status lightly, local hospital officials said. They realize that one hospital going on bypass often has a domino effect because it places a greater strain on other hospitals. Often, hospitals try to coordinate when they go on or off bypass to ease the overall burden, Ms. Dooner said.
Many hospitals, especially those in one-hospital towns, don't go on bypass status.
Gary Orlow, Lucas County EMS manager, said a hospital going on bypass not only shows that it's busy, but that the county's EMS system is working well.
About two years ago, the county started a Web-based system that tracks the status of metro Toledo's eight hospitals. Mr. Orlow said the system helps coordinate the flow of patients and “has been a tremendous help.”
There have been discussions at the state level about instituting a statewide Web-based system to alert communities about how busy a hospital's emergency department is.
Such a system would be invaluable during times of mass casualties or a deadly disease outbreak, Mr. Orlow said.
Most area emergency department officials said their patient volume is starting to decrease, but they're still busy.
Diane Smith, director of emergency services at MCO Hospitals, said lately her ER has frequently gone from relatively quiet to busy in a matter of minutes.
“It starts out with maybe only a couple of patients and you go to the bathroom and come back and there are three ambulances waiting, a Life Flight [helicopter] arriving, and the waiting room is full,” she said.
The Associated Press contributed to this report.