Wednesday, October 8, 2008

Parkland Hospital ER Death - More Details

I have a soft spot for Parkland Memorial Hospital. It is a county hospital that sees all-comers regardless of their ability to pay or legal status. I also did an externship there and can say from first hand experience that the ER is amazingly busy and they see about as much trauma as any other hospital in the country.

On September 19th a 58 year-old man died after waiting 19 hours in the emergency room. The event is, of course, tragic and hopefully lessons will be learned. The attached link gives a more detailed description of events, a time-lapse of his wait as well as the coroner's report.

I liked the quote from Dr. Arthur Kellermann from Emory University;

"My hunch is that it happens several times a week in hospitals around the country and it doesn't make the paper," he says. "And that's just completely and totally wrong."

When a clinic tells a patient that they can't be seen for 1-2 weeks what safe guards do you have in place to prevent a disaster? If a 58 year old male called your clinic with abdominal pain how long would he wait? Are they simply instructed to go to the emergency room? Told to call back if symptoms worsen? The lessons reach far beyond ER wait times. It would do all clinics some good to take a look at the effect of wait times on patients.

2 comments:

benweger said...

I'm also at a busy level 1 trauma center and I had nightmares about situations like this when I was a nurse there. Anecdotally, the biggest complaint we see is abdominal pain and is frequently tagged as a level 3 in the ESI triage system. "3's" are the ones that come up and bite you. Thankfully, our hospital has a policy of re-evaluating level 3 patients every hour prior to their assessment by a physician. So far, this has helped to prevent a lot of problems.

There are a number of problems that led up to this terrible event. Sadly, the medical community is largely aware of them and they all require an investment of both time and money.

Ben Weger
http://www.benweger.com

Colin Murphy said...

Hi Ian. I just found your blog from a posting you made on an HIStech Report from February regarding revenue cycles being tied to wait times.

This story is a shame. Unfortunately, perfect efficiency in the emergency room will never be achieved until we have more ER doctors than patients. Tech scholar, current Microsoft employee and former Infoworld Blogger Jon Udell produced a webcast for his "Screening Room" two years ago on the use of expert systems and domain expertise to reduce wait times in emergency rooms. The webcast was an interview with Dr. Donald Thomas, who teamed with my company, mTuitive, to create a solution to address this issue. The premise is that accruing and acting upon the correct and necessary information in real time can help to eliminate a lot of wait time. Expert systems packed with appropriate knowledge can eliminate unnecessary questions and provide all the requisite checks to maintain compliance with standard, patient safety protocols.

The link is here: http://weblog.infoworld.com/udell/2006/07/31.html#a1495.

I would be very interested to hear you insights on the role of this type of solution. If you have a chance, I can be reached at colin.murphy@mtuitive.com. Thanks in advance!