University of Chicago's ER Still Struggling with Crowding

Article excerpt

Byline: Carla K. Johnson AP Medical Writer

As University of Chicago Medical Center struggles to unclog its emergency department, one statistic keeps pushing back. Because of overcrowding -- a growing, nationwide problem -- the hospital turns away ambulances more often than any other ER in Illinois.

The city's premier South Side hospital turns away ambulances for 13 minutes, on average, each hour. No other hospital comes close, according to Illinois Department of Public Health numbers obtained by The Associated Press.

In addition, some ER patients wait more than 24 hours for a hospital bed to open upstairs in the hospital.

Earlier this year, the hospital agreed to pay a maximum $50,000 fine to settle allegations it had violated federal law when 78-year-old Maurice Ross died in the ER waiting room, after nearly four hours without care. Hospital officials insist the incident was a staff member's mistake and not part of a systemic problem.

A UCMC task force is quietly addressing ER crowding with some success, two years after the facility weathered a public relations nightmare involving an initiative to find community doctors for patients who use the ER for basic care. But other hospitals' closures and a shortage of primary care in the impoverished area mean nearly 70,000 patients a year still arrive at the ER seeking help.

The nonprofit academic medical center has struggled with emergency room crowding for years. Many at the hospital see the stubborn situation as a symptom of a health care system that leaves many poor people without care and appoints emergency rooms as the one place that can't turn anyone away -- a problem that may only get worse at other hospitals in years to come.

"It's really a manifestation of what's going on with health care in our country more broadly," said Dr. David Howes, the hospital's emergency medicine section chief, in an interview. "We are not alone and we are doing our very best to address this."

Crowding is a widespread national issue. Patients across the country are experiencing the longest wait times in ERs since reports were first made available in 2002, according to Press Ganey Associates Inc., a health care consulting company. Many experts predict the problem will get worse after the new national health overhaul expands insurance to 32 million more Americans.

In any hospital, patients compete for inpatient beds, whether they know it or not. More lucrative patients -- those with scheduled surgeries, for example -- often are moved first. To survive financially, hospital executives must be certain the mix of patients includes people with private insurance, which pays better.

Some patients actually cost hospitals money -- those without insurance and those covered by Medicaid, the state-federal health program for

the poor and disabled. University of Chicago's ER patients generally fall into those money-losing categories, Howes said.

Having private insurance didn't eliminate the wait for patient Paula Ellis, a suburban resident who's more affluent than many in the ER. The 55-year-old computer programmer waited more than 24 hours for a room to open up for her one day last month at UCMC. She came to the hospital's ER because she lost vision in her right eye.

"This was unexpected," Ellis said sitting cross-legged in an ER bed. "I was told I'd be admitted, but then they never found the bed. So that became frustrating because you can't sleep in here because it's loud, and it's light, and you're not feeling good."

That day, Ellis was one of five patients who waited more than 24 hours. They took up space in the ER, and the domino effect kept about 20 others waiting in the lobby. …