Wednesday, March 07, 2001

Hospitals continue to bar doors at record rate

By Tim Bonfield
The Cincinnati Enquirer

        Tristate hospitals set another record in February for the number of times they turned away ambulances from their emergency departments.

        Last month, 11 hospitals went “on diversion” 112 times, according to the Greater Cincinnati Health Council. That shattered the previous record of 82 diversions in January, which broke the previous record of 57 in November.

        All this has occurred even though public health officials report that the winter flu season has been milder than expected. Hospital officials say staff shortages continue as a declining number of emergency departments buzz with the normal variety of health problems.

    Figures reflect 14 hospitals that report diversions through the Hamilton County Communications Department. Each diversion reflects all or part of an eight-hour shift when a hospital asks life squads to take all but the most unstable patients to other hospitals.
       1999   2000   2001
  Jan.   10    42    82
  Feb.   31    14   112
    Source: Greater Cincinnati Health Council
        “It's the same set of problems we've experienced in previous months,” said Colleen O'Toole, vice president of the Health Council. “What struck me this month was how few shifts there were when no hospital was on diversion.”

        When hospitals lack the staff or bed space to handle more patients, they notify the Hamilton County Communication Center, which then helps notify the many life squad services in the area that all but the most critically ill patients should be taken to other hospitals.

        During February, at least one hospital was on diversion for part of nearly every day.

        • The VA Medical Center went on diversion 26 times; Jewish Hospital, 20 times; Christ Hospital, 18 times; Good Samaritan Hospital, 11 times; and University Hospital, 11 times.

        • On Feb. 13, hospitals set another record when seven went on diversion at once for an hour and a half: Christ, Mercy Anderson, Mercy Fairfield, Mercy Franciscan Western Hills, Jewish, University and VA Medical Center. Previously, no more than four hospitals had been on diversion at the same time.

        Response time for life squads has slowed because crews have to drive farther to find available hospitals and have to wait longer to get patients admitted. Exactly how much has not been studied.

        Patients, especially those with non-life-threatening problems, are waiting longer in emergency departments.

        So far, hospital and fire department officials say the sickest people are still getting the care they need. But no one can say how much farther the system can be stretched.

        “You keep spinning the roulette wheel and sooner or later you could end up with some serious consequences as a result,” said Bruce Smith, chief of the Colerain Township Fire and EMS Department and president of the Hamilton County Fire Chiefs Association.

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