Wednesday, November 29, 2000

Hospitals refusing patients

Flu season not here yet but diversions soaring

By Tim Bonfield
The Cincinnati Enquirer

        October set another Tristate record for diverting ambulances away from area hospitals, and it still isn't flu season.

        Nine area hospitals went “on diversion” last month a total of 45 times, according to the Greater Cincinnati Health Council. That's two more than September, which had been the highest month for diversions since record keeping began in May 1998.

        For the year, 14 area hospitals have declared 253 diversions. That's an 82 percent increase over the entire year of 1999, with two months of 2000 yet to be reported.

        “It has been more of the same,” said Colleen O'Toole, vice president with the Health Council.

    October set another record for local hospitals routing life squads to other hospitals with 45 diversions reported. Last October, there was one. Figures reflect the number of 8-hour shifts that hospitals were on diversion status in October:

    Christ: 12
    Deaconess: 9
    University: 6
    Bethesda North: 5
    Jewish: 4
    Mercy Anderson: 3
    Mercy-Fran. Mt. Airy: 2
    Good Samaritan: 2
    VA Medical Center: 2
    Total: 45
    Source: Greater Cincinnati Health Council

        Diversion status means that a hospital's intensive-care units and other key services have become too swamped to admit patients after they come to the emergency department. When this occurs, hospitals notify the Hamilton County Communications Department, which then advises area life squads to take all but the most unstable patients to other hospitals.

        In past years, local hospitals went on diversion primarily during the peak of flu season, which packs intensive-care units with elderly people suffering from flu-related pneumonia.

        But diversions are no longer seasonal. A nursing shortage combined with years of cutbacks in hospital capacity have led to diversions during normal levels of patient demand. Hospitals may actually have open beds, but increasingly, they lack the nurses and other personnel.

        The latest diversion figures illustrate this shift. While there were 45 diversions in October 2000, there was only one in October 1999 and eight in October 1998.

        Increased diversions indicate people are enduring long waits for emergency department care, but the big concern is how bad the hospital crunch will become in January and February. Those are the traditional peak flu months — and this year has been complicated by a nationwide delay in providing flu vaccine to the public.

        Hospital and EMS officials in Cincinnati and statewide are working to maximize hospital capacity this winter, Ms. O'Toole said. Several developments are expected in the next two weeks.

        • Dec. 4: the Ohio Department of Health will host a meeting in Columbus to address diversions in several Ohio cities.

        • Dec. 6: Cincinnati's Pre-Hospital Care Committee, part of the Academy of Medicine of Cincinnati, will meet to discuss proposed changes in the local diversion policy.

        • Dec. 11: Greater Cincinnati health officials plan to launch a week-long campaign to promote hand-washing as a way to prevent infections from spreading — particularly since fewer people have had flu shots this year. Several events will focus on schools and day-care centers, because poor hygiene among children is one of the ways that influenza spreads through a community.

        • Dec. 13: The Health Council and other organizations plan to hold a citywide media conference to discuss the upcoming flu season and hospital capacity.


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