Taking care of an emergency
Re “State imposes fines on medical centers,” Oct. 26
Some of the worse infractions were related to the continuing problem of emergency room overcrowding. There is consensus that the underlying cause of most overcrowding is the unavailability of inpatient beds. However, the real problem is that the existing supply of beds and available nurses are not managed efficiently. Specifically, the scheduling of elective admissions is often mismanaged, despite demonstrated solutions to this problem. When there is an unnecessary peak in admissions of these patients, who then fill all available inpatient beds, emergency room overcrowding is often at its worst. Nurses then have too many patients, threatening the quality of care.
A recent Institute of Medicine report, “The Future of Emergency Care in the United States,” calls for improved operations management at hospitals to address overcrowding. Before we invest billions of dollars by building bigger emergency rooms or more inpatient capacity, we should consider better management of current healthcare resources.
Eugene Litvak
Kathleen Kerwin Fuda
Boston
The writers are in the Program for Management of Variability in Health Care Delivery at the Boston University Health Policy Institute.
Start your day right
Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week.
You may occasionally receive promotional content from the Los Angeles Times.
