VA Hospital Adds Doctors to Emergency Room

The Veterans Affairs hospital in West Los Angeles is hiring more physicians for its emergency room after a task force found that inadequate staffing “jeopardizes both patient safety and the overall quality of care.”

The six-member internal task force appointed by the hospital’s chief of medicine determined in April that “the increased workload, increased complexity of illnesses and substandard ratio of attending physicians to trainees” put patients at risk.

Hospital leaders said they had appointed an emergency room director and were hiring an additional staff physician to cover daytime hours in the ER. Currently, two staff physicians work in the unit during the day, officials said.

VA administrators also are exploring a contract with a group of certified emergency room physicians to work at night. For now, fill-in doctors are used.

The task force estimated that its proposals, including the new hires, would cost more than $1 million.

Dr. Dean Norman, chief of staff for the VA Greater Los Angeles Healthcare System, said some of the changes were underway before the group finished its report. The ER treated 1,443 patients in the first quarter of this fiscal year, compared with 1,019 in the same quarter a year earlier.

Norman disputed the task force’s assessment that patients were at risk, saying members told him that “they were being dramatic.”

“That’s how they get management’s attention,” Norman said.

In an interview, task force members said they were not aware of any emergency room patients who had been harmed because of inadequate staffing.

Norman also said the emergency room now complies with the rules governing oversight of trainees and students.

The task force is not the first group to criticize the hospital’s emergency room in recent months. Many of the hospital’s own psychiatrists have faulted the VA’s decision to close its psychiatric emergency room in May 2004 and shift mental health emergencies to the main ER.

Mentally ill patients are now cared for by nurses and other staff who, according to the critics, are not adequately trained to handle psychiatric emergencies.

VA officials disagree, saying that care in the main ER is more coordinated than it was in the stand-alone psychiatric emergency room. Patients can get their medical and mental problems treated in one place, instead of shuttling between two.