Philadelphia Medical Malpractice Attorney Blog

Overcrowding in hospital emergency rooms is not just a problem in Philadelphia; it has hit emergency rooms across the tri-state area and the United States. More than 123 million patients vested emergency rooms in 2008, up 6 million from the year before. Many of those patients were in need or urgent care and waited nearly a half hour. The overcrowding of emergency rooms has placed extreme pressure on hospital staff and hospitals are looking for ways to cut delays and increase the quality of patient care.

It has become a trend in the United States for those with little or no insurance to use ERs as primary care physicians. This trend has overcrowded emergency rooms, placed extreme pressure on ER staff and unfortunately harmed patients who did not need to be harmed. In an effort to reduce ER visits, President Obama and Congress passed health care reform. The reform offered millions of previously uninsured Americans insurance.

Hospitals have also devised ways to reduce emergency room crowding. In some hospitals have placed ER doctors and triage nurses in the emergency room entrance to diagnose and treat patients with less severe injuries before they can be admitted to a hospital bed. Hospitals have also experimented with "hallway medicine." Patients were placed on gurneys in hospital wings to wait for rooms rather than waiting in the emergency room.

Some hospitals have decided to post wait times on hospitals billboards and text potential patients the wait time. Hospitals are hoping that patients will avoid long wait times and drive farther to attend emergency rooms with a shorter wait time. Those with the most severe injuries will still be attended to first but patients with less severe injuries can weigh their options and choose an ER with a shorter wait time.

Related Sources:
Some hospitals now post waiting time for ER

More Visits, Less Availability

A new study released in JAMA shows that the number of annual emergency department visits between 1997 and 2007 increased from 94.9 million to 116.8 million -- nearly twice as much as would be expected for population growth.

Also published recently was the Department of Health and Human Services' 2007 Emergency Department Summary (.pdf file here). Lots of interesting statistics.

Most of the increase in ED visits were due to Medicaid patients. One quarter of the 117 million visits to the emergency department in 2007 were made by patients with Medicaid or SCHIP. Seventeen percent of visits were covered by Medicare. In other words, 42% of hospital ED visits (50 million or so) are paid for by the state or federal government.

The graph to the right from the San Francisco Chronicle shows how emergency department use by Medicaid patients is now more than five times the rate of emergency department use by patients with private insurance - and since they are from 2007, these numbers don't include the impact from the recession.

Further breakdowns in demographics from the DHHS report include high ED utilization rates for children less than 1 year old (88 visits per 100 US infants), patients older than 75 (62 visits per 100 US persons), homeless persons (72 visits per 100 population), blacks (74.6 visits per 100 black persons), and nursing home residents.

In addition, the number of "safety net" hospitals - defined as those who treat patients regardless of the ability to pay - increased by more than 40% from 2000 to 2007.

Before you start blaming Medicaid patients for health care crisis, think about why there is a disproportionate use of emergency departments by Medicaid patients. If you or your child has a medical problem and few private physicians will accept your insurance, what are you supposed to do? You go to a place where they will accept your insurance and you get relatively timely care (as opposed to an appointment 4 months in the future). Although there are undoubtedly people that abuse the Medicaid system, in general, it isn't the patient's fault for having Medicaid. It is the fault of the government for failing to adequately fund and monitor the Medicaid program.

With the increase in visits, there are longer waits and less availability of medical care.

The new health care bill provides insurance coverage to the millions of people in the United States but government red tape is preventing some families in New Jersey from receiving the coverage they need.

New Jersey FamilyCare provides health insurance coverage to low income families for little to no cost. According to the company families will receive coverage up to one month after submitting claims to get coverage; however some families are waiting longer than six months.

Unfortunately, those families and individuals without health care coverage do not receive optimal care when they visit emergency rooms. Health care reform was passed to address this problem but many families across the country are met with piles of paper work that lead to nothing but heart break and aggravation.

Related Sources:
Health Alert: NJ Health Insurance

Researchers have predicted that the new health care bill will mean longer waiting times at emergency rooms across the United States.

The new health care bill will insure 32 million Americans and add 16 million patients to Medicaid. Medicaid patients are by far the largest consumers of emergency room and such a large addition may place a strain on the already under staffed and over worked emergency room. The study also found that there is a shortage of family care physicians in the neighborhoods where the majority of the newly insured live.

Longer wait time at the emergency can be a matter of life of death. Also the more patients using the emergency room for situations that are not an emergency can cripple the staff and send many away without proper care.

Related Sources:
Claim: Health Reform Will Mean Longer ER Wait Time

Consumer Reports conducted a nationwide study on the amount of central-blood line infections at hospitals and most hospitals in the Philadelphia area were graded above average. Pennsylvania is one of only 23 states that have a policy for all hospitals in the state to mandatory report infections.

Hundreds of thousands people die each year in hospitals due to infection with the most common being a central line infection. Central lines are catheters that are placed in a major vein to quickly deliver medication or fluids to a patient. One third of patients who die in hospitals from infections are from central line infections that occur in intensive care units.

In the Philadelphia area, St. Christopher's and Hahnemann University Hospital scored better than average along with A-I DuPont in Delaware. Surprisingly Children's Hospital of Philadelphia was graded well below average and officials from the hospital have acknowledged the problem and have implemented a system that is already producing better results.

Research has shown that central line infections are relatively easy to avoid with some very simple steps and good hygiene practices. Two thirds of infections can be prevented if hospital staff wash their hands before and after touching a patient or a catheter, disinfect the patient's skin before applying the catheter and wearing protective gear such as gloves, masks, caps, and gowns when caring for a central line patient.

Related Sources:
Consumer Reports exclusive on hospital infections

The Shops at Liberty Place at 17th and Chestnut Street in Center City Philadelphia have a new innovative addition to their ground floor, Drexel University's walk-in clinic. The facility is the first in the city but other city health systems are planning to build similar treatment centers in the area.

The clinic will be open 7 AM to 7 PM and is aimed to cater to the millions of people who live and work in Center City Philadelphia. Doctors and nurse practitioners will staff the clinic and will be able to diagnosis and treat routine medical conditions and if need be patients will be referred to Drexel specialists. Also at the clinic will be a state of the art drug vending machine that is able to easily provide patients with the most common generic drugs without them having to visit a pharmacy.

Doctors are hoping that the convenience of the clinic and the onsite prescription vending machine will help people to see doctors more often and catch problems early. There is also hope that the clinic and others like it will alleviate some of the traffic visiting emergency rooms after the recent concerns about treatment at local emergency rooms.

Related Sources:
Walk-in clinic opens in Center City
Kenneth Rothweiler Appears on Fox 29 Good Day Philadelphia to Discuss Emergency Room Treatment

It was once believed that 2 in every 100,000 children are victims of a stroke but thanks to the work of doctors at the Pediatric Stroke Center at The Children's Hospital of Philadelphia it is now estimated that 12 in every 100,000 children suffer from strokes.

Strokes are so uncommon in children that parents and many doctors never imagine the child is suffering from a stroke although they may be presenting with the signs and symptoms associated with a stroke. In most cases strokes aren't recognized in children until 24 hours after the first sign or symptom. In all stroke cases, time is of the essence, the faster a stroke is diagnosed and treated the less brain damage the patient will experience. Those at the highest risk for a stroke are children born with a hole in their heart and those with vascular problems however the risk is so low that they are not routinely screened for a stroke.

Children suffering from a stroke present the same symptoms of adults suffering from a stroke. The child may lose the ability to walk, speak, use one side of their body, and may become disoriented. Child stroke suffers are more capable of leading a healthy and active life than those who experience a stroke as an adult. A child's brain is still developing and is able to work around those areas affected by the stroke and many return to full health with no disabilities or impairments.

Related Web Sources:
Children Don't Have Strokes? Just Ask Jared

The emergency room of a hospital is supposed to be a place where patients receive care in a timely way for a condition that needs immediate attention and can't wait for the patient to see his or her regular doctor. Recently a patient went to a local hospital and was left waiting in the ER despite complaints of crushing chest pain. This complaint is a clear sign of an impending heart attack, and in Philadelphia,at Frankford Hospital, the patient died before anyone even came to examine him. The whole event was captured on videotape, and showed how the patient was left sitting in the emergency room without any care until he eventually went into cardiac arrest and died. We have represented families of victims who have suffered similar losses, and have tried to get emergency rooms to understand that complaints of an impending heart attack must be taken seriously and immediate medical attention is required. Such tragedies like this should not happen with today's modern medical technology and qualified medical personnel staffing our emergency rooms. When they do, serious and inexcusable lapses of medical attention and care have occurred.