By Emily Berry, Staff Writer
Chattanooga Times Free Press (Tennessee)
Copyright 2006 Chattanooga Publishing Company
Chattanooga’s emergency rooms suffer from the overcrowding that affects ERs around the country, but overall the quality of care here is better than in other cities, hospital officials said.
A recent report from the Institute of Medicine, part of the National Institutes for Health, found widespread problems in the nation’s emergency care system, including overcrowding and a shortage of qualified physicians, a lack of qualified pediatric trauma specialists, and fundamentally different EMS and 911 systems.
Most of those things either are not problems in Chattanooga or are improving here, said Dr. James Creel, chief of emergency and disaster medicine at Erlanger hospital.
“I think the study was absolutely correct, but we have our heads above the water,” he said. “As a community we do have the players get together and really address some of these issues.”
Dr. Creel said the city’s single medical communication and dispatch system, called Chattanooga MedComm, is the key to the success and continued improvement of emergency care in the city.
MedComm does not answer 911 calls but coordinates ambulance response around the community. Each month, EMS officials and representatives from Erlanger, Memorial Hospital and Parkridge Medical Center meet to discuss ways to improve emergency response and coordination of care.
“It’s a model for the state,” Dr. Creel said.
Lowell Hardin, director of emergency services for Memorial Hospital, echoed Dr. Creel’s assessment, crediting MedComm and hospital coordination with improving emergency care for patients.
When a hospital becomes full, or is overwhelmed with severe injuries, it can go on divert status, meaning some patients in ambulances are directed to other hospitals. Trauma patients always go to the nearest qualified center, which in Chattanooga is Erlanger hospital.
Over the last two years, Erlanger has cut its diversion rate by 60 percent, so the hospital is on divert status only 5.8 percent of the time, hospital spokeswoman Jan Powell said.
“I don’t hear from the Chattanooga area the same kinds of issues you hear from some of the other major metro areas, particularly around hospitals going on diversion because of lack of ER capabilities,” said Mike Huggins, chief operating officer at the Tennessee Hospital Association.
Parkridge Medical Center spokeswoman Sara Maloney said the hospital’s Lean Health Care initiative has cut down on emergency room waiting time and improved the efficiency of care.
The average wait time from triage — assessment and sign-in — to seeing a physician is about 41 minutes, and the time from physician visit to discharge averages about 75 minutes, she said.
The hospital’s emphasis on efficiency improves patient care, she said.
“Nurses aren’t running around all the time, and they have more time to spend bedside,” she said.
Mr. Hardin and Dr. Creel both said that part of the long-term solution to emergency room overcrowding is out of a hospital’s control. People won’t come to emergency rooms as often if they are insured and can get in to see primary care physicians in a reasonable time, they said.
Ms. Huggins said part of overcrowding also is due to an “I want it when I want it” attitude among patients who want to be seen immediately, even if it’s after regular physician’s hours.
“We obviously need to make better use of our primary care physicians, clinics, and other opportunities for primary care,” he said.