2 comments on “… — … LWBS …—… ER inpatients …—… EMS park …—… Overcapacity

  1. This is SUCH an important issue – certainly a much bigger problem for the general ED than peds ED at this point, but actually patients of all ages suffer in any ED where there are not enough beds to be seen by the ED physicians.

    I am not an adminisrator, but I DO wonder what would happen if there were more long term facility beds, a hospice center off site tomorrow. It seems to me, that the lack of adquate level II and IV level beds in the community (PUBLIC!!!) … btw what is level III?….. is a government failure – no matter what their colour. There is no point punting people out early from the wards – esp if they are going back to a rural community with less access to follow-up. I like the idea of my internist friend who is wanting to get a ‘healthy and home’ for adults going. absolutely!! There is also evidence (I have learned form her) about the great deconditioning that occurs to the elderly when they are in hospital too long because there is no appropriate other facility.

    there are inherent inefficiencies in the system i’m sure – perhaps helped a great deal by dashboard manuevers., or rotaing ER beds, ha! (MI between first and second trops whilst back in the waiting room?), but I cannot help but think that greater non-tertiary care resources would help access and be much better for the patients currently ‘stuck’ in beds who might do very well in a different ‘bed’ outside of the tertiary care hospital. My now deceased great aunt ( a huge fan of Tommy Douglas ) before you were born N, – predicted the fall out of fewer Level II beds.

    The lack of dignity for anyone in a hallway in the ED breaks my heart – esp the elderly – often frightened and alone.

    Re it not being the fault of the ED – you are preaching to the choir honey!

    • HI Vicki,
      thanks for your thoughts. Speaking to Paul again after my post. He couldn’t stress enough two things:

      1) the ADMITTED PATIENT BENCHMARK is the only one we should focus on because this is where the problem is. So I have taken out the 4h benchmark as it creates a false sense that we can tinker with the ER and fix things.

      2) The long-term care beds have to be PUBLIC. There IS money in the system for this – we currently pay THREE times that much using an acute care bed in hospital for what should be a long-term care patient. Moreover … private homes bankrupt our senior citizens [he cited $6000/mo]. They also “evict” them when they’re a little to high maintenance – guess where they get turfed?

      I think this is what drives those doctors into politics [Swann and Sherman] … we have to find a way to create change … this is the only thing I know. That document from 2006 was written by [among others] Eddy Lang and Grant Innes – both Editors for the CJEM. It’s evidence-based and it calls for these things in 2006 … a full 4 years before Cookiegate! V disappointing – this kind of stuff is why we left Kenya in the first place.

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