Tulsa Oklahoma feels ER time crunch

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Tulsa feels ER time crunch

By KIM ARCHER Tulsa World Staff Writer 1/26/2008

Hospitals follow national trend of longer waiting times

If you go to one of Tulsa's five hospital emergency rooms for the flu,

you might want to pack a picnic lunch and bring a good book.

It is a good bet you will be waiting several hours to see a physician.

" If you ask anybody who has to go to the emergency room, the most

common response is, `I dread it,' " said Dr. Roemer, assistant

residency director of Emergency Medicine at the University of

Oklahoma-Tulsa. And for good reason.

Wait times are increasing in hospital emergency rooms across the

country, up 36 percent from 1994 to 2004, according to a national

study released last week by Harvard Medical School researchers.

Things are no different in Tulsa, area emergency department doctors

and hospital officials say.

" We're overloaded, as are all the others, " said Boone,

corporate vice president of St. Medical Center.

The Tulsa World gathered average emergency room wait times for the

major hospitals in Tulsa.

Each hospital computes its wait time differently from others.

According to hospital officials, St. Medical Center has an

average wait time of 4 hours. Southcrest Hospital

has an average visit time of 3 hours, while St. Francis Hospital has

an average visit time of 4.5 hours. Hillcrest Medical Center has an

average door-to-seen-by-physician time of 45 minutes, and Oklahoma

State University Medical Center has a door-to-seen-by-physician time

of 15 minutes.

While the national study noted heart attack patients and others in

most need of medical attention also are waiting longer to be seen by

doctors, local hospitals say that is not so here.

" The critically ill and injured are our priority, " Boone said.

Area hospital officials said protocols are in place to identify those

patients and get them in to see a physician immediately.

The study, released last week in the journal Health Affairs, said the

reason for longer waits is that the number of emergency room patients

is rising while the number of available hospital beds is falling.

Between 1994 and 2004, the number of annual emergency department

visits increased from 93.4 million to 110.2 million, while the number

of existing emergency departments dropped 12.4 percent, the study said.

" Bed availability is absolutely part of the problem, and that is true

across Tulsa and the rest of the country, " said Dr. Jeff Dixon,

emergency department physician at Tulsa's Hillcrest Medical Center.

When the emergency department is unable to admit patients to the

intensive care unit or other floors because beds there are filled,

those patients end up " boarding " in the emergency room, officials said.

As a result, nobody is leaving the ER to move to an inpatient bed, so

there is no room for others to be treated.

" The emergency department becomes a temporary intensive care unit, "

Boone said.

Doctors note Tulsa's lack of access to primary care and its high

number of uninsured patients aggravate the situation.

Said Roemer, " If you're in a city that has less primary care access

for lower socioeconomic groups, the only option is the ER. "

Tulsa definitely is one of those cities, he said.

While nonurgent patients help to crowd the area's emergency rooms,

they cannot be blamed for the problem, Roemer said.

" To say that somebody with a sore throat is delaying the care of a

heart attack patient . . . that is not generally true, " he said.

What is true is that primary care access for uninsured and low-income

Tulsans will free up emergency rooms, Roemer said.

OU-Tulsa and the Oklahoma State Health Department soon will be working

together to improve the ability of patients to be seen more quickly in

emergency rooms across the state, he said.

The organizations will look at using practices that have been

successful in other parts of the country, Roemer said.

" For example, when ERs are full and holding admitted patients in the

ER hallways, these patients can be safely moved to a more comfortable

area of the hospital promptly opening bed space for those in the

waiting rooms, " he said.

And two super health clinics — called HealthPlexes — are in the works

to serve low income and uninsured residents in north and west Tulsa.

That would free up Tulsa's ERs to treat more true emergency patients.

It is a complex problem that likely will require an equally complex

solution. But Tulsa is taking steps to assuage the ER crisis, Roemer said.

" Tulsa's making a real effort and is moving in the right direction, "

he said.

http://www.tulsaworld.com/news/article.aspx?articleID=20080126_238_A1_hHosp18031