Emergency Department overload a national problem

By Julie Fann
Star Staff
jfann@starhq.com

   Hospital Emergency Department overload has become a critical, nationwide problem, according to a recent survey conducted by the American Hospital Association. The AHA reported that 1,501 hospitals responded to their survey, representing 36 percent of all hospitals with emergency departments. Lack of available staffed, critical care beds was the number one reason cited for Emergency Department over-capacity.
   The survey concluded that more than six out of 10 hospitals reported that they are filled to capacity and cannot easily accommodate additional patients. Emergency Department capacity is a pervasive problem across the country. More than 90 percent of large hospitals with 300 beds or more report EDs "at" or "over" capacity. One-third of hospitals reporting a problem are forced to go "on diversion" -- rerouting ambulances to nearby EDs.
   "Overcrowding in the nation's emergency departments is a sign of a troubled system," said American Hospital Association Executive Vice President Rick Pollack. At the same time, patients have more needs and workers are short. Also, costs are soaring for goods and services needed for communities to do their jobs.
   Twenty percent or more of the hospitals reporting a problem with overload also reported an average RN vacancy rate of 16 percent. The emergency department visit volume has grown by 5 percent from 2000 to 2001. Sycamore Shoals Hospital qualifies as a rural hospital and is not designated as a trauma center. According to the AHA study, 26 percent of rural hospitals are at capacity and 47 percent are over-capacity. When all hospitals are included, 28 percent are at capacity and 34 percent are over-capacity.
   Although ED capacity is a problem across the country, it is most acute for the Northeast and the West Coast. The East Tennessee region is included in the East South Central region in the study, a region that reports 27 percent of its hospitals at over-capacity. Sycamore Shoals has approximately 125 beds, and hospitals with that number, nationwide, experienced 32 percent "at-capacity" and 45 percent over-capacity.
   Emergency Departments represent the most critical access point to our nation's health delivery system because they are available 24 hours a day and 365 days a year. They are a guaranteed access point for all who need care regardless of ability to pay. Emergency Department overload is also symptomatic of other capacity issues, and it is expected that these problems will increase.