South Bay hospitals work to reduce emergency room wait times

This article originally appeared in the Daily Breeze

The emergency room doctors at Torrance Memorial Medical Center are used to a winter rush — with perhaps 230 patients in the ER on their busiest days.

But the ER right now is already hitting those numbers, with visits up 15 percent over last year at this time.

“We are seeing days when our average daily census is 200 to 230 patients and sometimes higher than that,” said Dr. Zachary Gray, a medical director of the Torrance Memorial Lundquist Emergency Department. “We’re now seeing in the quiet part of the year numbers that rival our volumes historically in the busiest part of the year.

“That is very difficult for us to manage. It’s a physical space and infrastructure problem at this point.”

Californians experience some of the longest waits in hospital emergency rooms — an average of six hours and 18 minutes from arrival to admittance and nearly two hours more to be tucked into a bed — according to statistics compiled by the federal Centers for Medicare and Medicaid Services.

But South Bay hospitals are funneling resources into their ERs to prevent lengthy wait times through staffing changes, expanded facilities and operating efficiencies.

At Torrance Memorial, the median wait time to see a doctor is about 45 minutes, Gray said, a slight increase from the beginning of the year.

According to the Centers for Medicare and Medicaid Services, if a patient is treated and released from the ER, the median wait time from arrival to discharge is three hours and 43 minutes at Torrance Memorial, five hours and 16 minutes at Los Angeles County Harbor-UCLA Medical Center near Torrance and three hours and 42 minutes at Providence Little Company of Mary Medical Center in Torrance.

The median wait to see a health care specialist — whether nurse practitioner, doctor or otherwise — is one hour and 17 minutes at Torrance Memorial, 59 minutes at Harbor-UCLA and 37 minutes at Little Company of Mary, statistics showed.

Although Harbor-UCLA Medical Center said its ER visits have declined slightly over the past year, the wait times have increased as the staff adjusts to its expanded emergency services facility.

“We’re still getting used to the new facility so our flow isn’t quite as polished as it was previously,” said Dr. Mike Peterson, director of operations for the Department of Emergency Medicine at Harbor-UCLA. “But our overall treatment time is actually better, so, in the end, patients don’t spend as long (in the ER).”

To address the flood of patients, Torrance Memorial increased its nurse staffing and the number of physician shifts and broke up the waiting room, tagging patients into particular pods.

“That way the physicians know how many patients they have waiting to be seen as soon as they’re triaged,” Gray said. “It reinforces their sense of responsibility, and you start to care more about the numbers.”

The ER expects to have more staff by Nov. 1.

Local hospital officials attribute many of the striking changes in ER operations to the Affordable Care Act, commonly known as Obamacare, the government-sponsored health care marketplace implemented a year ago.

“We’ve seen a persistent rise in patient visits over the past six months,” Gray said. “Anybody you ask candidly is going to say that’s due to the Affordable Care Act.

“What we’ve learned since (Obamacare) was instituted is there is a broad reservoir of people who did not seek medical care before because they were afraid of the cost and didn’t have insurance. The Affordable Care Act has given those people the illusion of access to care. They have this insurance card so they feel comfortable going to the hospital because they know someone will help them pay their bills. These are people who didn’t come before.”

And fewer people are getting fed up waiting in ERs and leaving without being seen, local hospitals noted.

At one point, about 12 percent of patients would leave the pediatric and adult ERs at Harbor-UCLA Medical Center before they were seen by a doctor, Peterson said.

The number is now down to 8 percent, which he acknowledged is still quite a bit higher than the 1 or 2 percent found acceptable for private facilities.

“Every time someone leaves without being seen, we are very, very concerned,” Gray said.

Torrance Memorial’s number hovers around 1 percent.

“We want it to be zero, but it’s just not attainable,” Gray said. “If you’re coming after work because your doctor is closed and you know you don’t have an emergency, and you walk into the waiting room and see 20 people waiting, you’re going to cut your losses and turn around.”

Gray noted that no matter how well local hospitals attempt to fend off lengthy wait times, it’s not possible to staff for a surge.

“No matter how efficient we are, if 25 people show up in the ER in one hour, the wait times are going to be long,” he said.

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