ACEP Chief Rails Against ED Diversions, Scheduling
Yet it happens all the time in U.S. hospitals where "ambulances are lined up waiting in a queue, waiting to get someone checked into that ED, sometimes as long as two or three hours, and that's because there's a hospital patient in that ED bed."
Schneider lashes out against the U.S. healthcare system that she says allows this to go on, and even make the problem worse. For starters, she says, nursing homes often don't accept patients from hospitals on the weekend.
Also, many hospitals could organize elective surgeries more efficiently, on a seven day-a-week schedule rather than a five-day one, to avoid backing up EDs in the early week peak and provoking many ambulance diversions.
"For many, many reasons, elective surgery patients are often brought into the hospital on Sunday, Monday, and Tuesday and undergo operations on Monday, Tuesday and Wednesday. One reason is because the services they need, such as occupational, physical, respiratory therapy – all that stuff they need to recover from their surgeries – operate only five days a week," Schneider said.
It's those elective cases, she says, that take up hospital beds, leading to:
- ED flow impediments
- ED patient boarding during peak times
- Patients becoming exasperated and stressed
- More avoidable deaths
"Very few services these days are just open Monday through Friday. I can go to the bank, the dry cleaners, and the post office on Saturday. But hospitals aren't fully open on Saturdays," she explained. "This flow through the hospital is really essential to keep the emergency department open, so patients don't die, and in this particular case, don't die from heart attacks."
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Her late aunt's situation illustrates the problem.
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