Friday, August 31, 2007

Inside the ER during a pandemic: What you don’t see on TV

Ever been to the emergency room or had family or friends who've rushed to the hospital only to sit and wait –- sometimes for hours and hours -– before seeing a doctor? If so, then it should come as no surprise that overcrowding in emergency departments is a huge problem.

According to the Institute of Medicine, which released a series of reports this summer on the state of our country's emergency departments, emergency room visits grew by 26 percent between 1993 and 2003. During the same period, the number of emergency departments dropped by 425 and the number of hospital beds fell by 198,000. Every minute of the day, an ambulance is diverted from a crowded emergency department to one that is further away, and some people have to regularly wait as long as two days before getting needed care.

So what does the extra wait in the emergency room have to do with pandemic flu? Well, if today's routine emergencies are filling ERs to capacity, how can we cope with an additional 10 million hospitalizations that are predicted by the Department of Health and Human Services to occur during a severe pandemic flu outbreak? Everyday emergencies won't go away during a flu pandemic. Instead, our system will be more overburdened than ever before.

What can hospitals do? When preparing for the worst, it helps to have a bit of wiggle room. In the health care world, that idea is called surge capacity –- the ability of the health system to expand and adapt to the growing number of patients that can be expected during an influenza pandemic.

Just as we buy extra supplies and develop plans for home, hospitals, too, need additional resources to be able to expand their capacity to operate during a flu pandemic or other times of peak demand.

So where do you come in? You can help hospitals improve their surge capacity by contacting your elected officials and let them know you are concerned. Reach out to your local, state or congressional lawmakers and tell them that hospitals, along with the state and local health departments, need increased preparedness funding, staff and training so that they can be ready to handle the worst. Because in the end, it could be you or your family in need of that hospital bed.

1 comment:

Anonymous said...

Wishing for surge capacity is all well and good. But once again, there is an aspect of a pandemic, or any other large medical emergency, that is being passed over.

Given the current legal environment for health care, and the lack of reasonable restraint on frivolous lawsuits, there is an easily foreseeable aspect of a pandemic that is not being addressed.

In the event of a pandemic, the US health care system - hospitals, clinics, EMS, etc - will do everything in their power to save as many people as possible. In countless cases, health care workers themselves will die because they continue to care for the sick.

After the pandemic passes, or actually, after the first wave passes, the lawsuits will begin. Thousands of lawsuits will not only clog our legal system, but will choke the surviving health care providers with the costs and manpower necessary to begin defending against every claim that not enough was done to save a victim of the pandemic. By the time the second wave comes around, hundreds, if not thousands of health care entities will be facing bankruptcy before a single case is settled.

A possible solution to this pattern would be to pass a federal law that covers declared disasters (or national emergencies, or whatever the appropriate term would be) in which no one can file a lawsuit against a health care provider, or any of its parts, until there is clear evidence, as determined by a panel of medical experts before said filing, of intentional harm.

It is not enough to allow the health care entity to use the disaster declaration as a “defense,” similar to the “good Samaritan” laws that many states have. The costs of beginning the legal process in order to use such a “defense” would quickly overwhelm the already overstretched entities.

No, this law must require that before a lawsuit can even be filed, the plaintiff must be able to show clear, intentional harm. Not just negligence, not just lessening the suffering of a dying patient, not just failing to provide a standard of care that was actually no longer possible, but clear intent to harm someone.

Unless such a law is passed, our doctors, nurses, emergency medical technicians, hospitals, etc. will save millions of lives during a pandemic – and then get sued out of existence because they did not manage to save everyone that was sick.