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Hospital cutting ER delays
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Kay Smith talks about the effort to reduce overcrowding in the ER.

Local hospital officials were not surprised when a national report this week indicated that the average patient waits about an hour to see a doctor in the emergency room.

"We certainly have seen an increase in our total volume each year that I can remember," said Kay Smith, operations manager for emergency services at Northeast Georgia Medical Center.

According to the report released by the Centers for Disease Control and Prevention, 119 million visits were made to emergency rooms in 2006, a 32 percent increase from 10 years earlier.

Meanwhile, the number of hospital emergency departments dropped from almost 4,900 to fewer than 4,600.

In 1997, the average length of time an ER patient waited to see a doctor was 38 minutes. By 2006, it was 56 minutes.

Smith said she was unable to make a comparison because until recently, Northeast Georgia Medical Center did not track ER wait times. But under a new electronic records system that was installed two months ago, the hospital has begun collecting that data.

"Right now, we’re at about 60 minutes (wait time)," Smith said.

The hospital has emergency departments at both the main campus and Lanier Park campus. In its 2006 fiscal year, the medical center saw a total of 96,136 ER patients. In 2007, the total was 99,456 visits, a 3.5 percent increase in one year.

The CDC report cited two main reasons for ER overcrowding: too many patients going to the ER when they don’t have a true emergency, and hospitals having to hold patients in the ER rather than admit them because there are no beds available.

The medical center has taken steps to address both of those issues.

On June 1, the hospital implemented a new payment policy for the ER. All patients who come in will be evaluated, but those whose condition is not an emergency must pay up front if they want to be treated. People without insurance pay $150; insured patients pay their co-payment.

Those who choose not to be treated in the ER are given a list of primary care providers they can go to instead.

Smith said it’s too early to judge the effect of the new policy. But she said patients seem to be accepting the change.

"By and large, people are managing it very well," she said. "Often it’s just, ‘I didn’t know where else to go.’"

Melissa Tymchuk, spokeswoman for Northeast Georgia Medical Center, said ER volume did decrease slightly in June and July compared to the previous year, but it’s not yet known whether more patients are choosing to get treated in a primary care setting.

"We’re still looking at what percentage were nonemergent," she said.

As for problem of not having enough beds to admit ER patients, the hospital has at least a partial solution.

"We have opened an ‘express admission unit’ that gets patients out of the ER quicker, opening up beds for new patients," said Smith.

She said this transitional area is a large room with eight beds, separated by curtains for privacy. "Patients spend an average of one to two hours in that area," she said.

In the ER itself, there are 44 beds on the main campus and 12 on the Lanier Park campus.

Next spring, when the new North Patient Tower opens, the Lanier Park campus will close, and its staff and equipment will be moved over to the main campus. But Smith said the total ER capacity will not change.

"Opening the North Patient Tower will free up space to expand the ER over here," she said. "We will be able to see the same volume as before."

Tymchuk said the Tower also could cut down on wait times in the ER because there will be more inpatient beds for people who need to be admitted.