Significant gap exists in medical services for ER patients

Almost three quarters of hospital emergency department administrators nationwide report that lack of medical specialists at their facilities poses a risk to ER patients – in some cases a very significant risk.  They also express concern that health reform will cause additional ER crowding and that mental health services are becoming increasingly inadequate.

Those are among key findings of a new survey examining staffing and operational trends at over 600 hospital emergency departments across the country. Conducted by Schumacher Group, a national emergency department management firm, the survey underscores a range of challenges facing America's hospitals, which handle some 120 million emergency patient visits each year.

According to the survey, 74 percent of emergency department administrators believe that lack of specialists such as orthopedic surgeons, neurosurgeons and even general surgeons poses at least a moderate risk to patients.  Close to 40 percent indicated lack of specialists poses a "significant risk" or a "very significant risk" to ER patients.

"There is a 'golden hour' after patients experience trauma or severe illness when it is crucial that they receive specialty care," notes William "Kip" Schumacher, M.D., chief executive officer of Schumacher Group.   "When specialists are not available to provide care, patients must be transferred elsewhere, and the critical hour may be lost."

Patient transfers caused by lack of specialty coverage can lead to severe complications and even death, in addition to increased costs and inconveniences for patients, Dr. Schumacher observes.  

The survey further suggests there is a significant gap in services for mental health patients.  Eighty-six percent of hospital emergency department administrators said their facilities are sometimes or often unable to transfer mental health patients to inpatient facilities in a timely manner.   Due to lack of beds at inpatient facilities, many mental health patients must be boarded at the ER for days at a time.  Some emergency department administrators said their facilities have experienced boarding times for mental health patients of one week or more.  Sixty percent said patient care at their facilities is compromised as a result of long mental health patient boarding times.

"The mental health problem in America is being swept under the rug for hospital emergency departments to deal with," Dr. Schumacher says.  "We need a more proactive way to deal with this challenge."