Monday, September 15, 2008

It’s About Time

Hospital Emergency Rooms in Massachusetts are no longer allowed to declare “diversions.”

A diversion is when the hospital issues a notice that its ER is overcrowded and will no longer accept ambulance patients.

According to the September 13 issue of The Boston Globe, ER diversions have been prohibited by the state’s Department of Public Health with the only exceptions being a “code black” condition such as a major fire within the hospital. The reasons given for the prohibition were that the practice of diversions “has done nothing to solve the underlying problem…. [of] patients backing up in ER hallways because hospitals have no open beds” and that the practice has caused problems, “interfering with patient choice, increasing the time patients spend in ambulances, tying up the vehicles, and shifting crowding to other hospitals.”

What was not mentioned was that a hospital lacks open beds because it does not manage its admissions so as to provide adequately for ER patients, even though the need is predictable, particularly in the large hospitals that have declared diversions most frequently.

Also not mentioned were the long-established admitting practices that have the effect of giving priority to the private patients of the hospital’s medical staff over patients arriving by way of the ER.

The ER has long been seen as being in competition with private practice with the result that ER patients have been systematically discriminated against.

Now, it seems, hospitals are being called on it.

It’s about time.

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