By Annette Wells
Las Vegas Review-Journal (Nevada)
Copyright 2006 DR Partners d/b/a Las Vegas Review-Journal
Southern Nevada hospitals are complying nearly 70 percent of the time with a state law requiring them to accept patients from ambulances within 30 minutes of their arrival at emergency rooms, Rory Chetelat, manager of emergency services for the Southern Nevada Health District, told a panel of lawmakers on Tuesday.
In addition to requiring hospitals to meet the 30-minute deadline, the law also mandated a study of patient transfer times between ambulances and emergency rooms. Chetelat, who was commissioned to do the year-long study, released some data from the study on Tuesday at a Legislative Committee on Health Care meeting at the Sawyer Building.
Transfer times measure how long it takes from the ambulance’s arrival with the patient until the patient is received by hospital caregivers. Though hospitals are not subject to any penalties or liabilities for not complying with the law’s 30-minute deadline, that data is being tracked and included in the study.
The study is intended to identify where emergency care is slowest, a distinction no hospital would want, health officials say.
“Overall, in EMS (emergency services), we need 90 percent of all transfers to occur within 30 minutes in order to keep the system viable to respond to 9-1-1 calls,” Chetelat said.
Senate Bill 458 was introduced by Sen. Joe Heck, an emergency room physician, after emergency medical providers complained of waiting up to two hours to move on to the next emergency because hospitals were overcrowded.
Emergency medical providers must remain with the patient until they are off their gurney and received by the hospital.
The law also called for a computer system in each emergency room to track how long patients wait before they are admitted to the emergency room. That information is sent to Chetelat, who is analyzing that data.
Between March and May of this year, 24,407 transfers were logged into the computer system, which represents about one-third of all patients transferred from ambulances to emergency rooms, Chetelat said. Of those transfers, 16,406 occurred in under 30 minutes.
Chetelat said the average wait for a transfer so far this year is about 38 minutes. Between January and May of last year, the average time it took emergency medical personnel to transfer a patient to a hospital was 50 minutes.
In addition to the wait times, hospitals are asked to track additional information, including whether or not they are over capacity at the time, if they have a staffing or nursing shortage and the extent of the patient’s health needs.
“Our hospitals definitely have ... a capacity issue,” Chetelat said of the data he’s collected so far. “And, there’s still the issue with psychiatric patients being held in emergency rooms, which contributes to the capacity issue.”
Still, committee members said they were pleased with the preliminary information and efforts by hospitals to improve patient wait times.
“It’s kind of nice to see the improvements taking place,” said Sen. Maurice Washington, the committee’s chairman.
Sen. Sheila Leslie, vice chairwoman of the committee, said a full study should reveal a lot about what’s ailing the area’s emergency care system.
Chetelat agreed. “Are we there yet? No. There’s a lot that needs to be accomplished,” Chetelat said of the system.