Day: February 24, 2005

Emergency Room Overcrowding Reported at LMRC

This article, in the Lakeland Florida Ledger, is about 20 patients that were diverted from Lakeland Regional Medical Center in just over 6 hours this past Tuesday.  Each of these 20 potential admissions represents  $50,000 to $75,000 in missed revenue. The cause for this emergency department overcrowding?  A bottleneck in the ICU.  This was their first complete diversion, attributed to increasing ED visits and hospital admissions.  In addition to lost revenue, the diversion increased costs as the hospital geared up efforts to clear beds for new admissions. Two common causes for ED diverts are bottlenecks in the ICU and Telemetry.  Why?  Many patients end up in these two units when they need monitoring, regardless of their acuity.  Various studies have put the percentage of inappropriate ICU admissions between 17 and 23 percent.  These are avoidable ICU over-stays, readmissions or off-service admissions made in an effort to "bring the patient to the monitor."  This care model provides more than appropriate care in the highest cost setting for this group of patients. One solution to this problem goes by various names: universal bed, universal unit, variable acuity beds, flex beds and flexible monitoring.  The goal is to provide appropriate care in the lowest cost setting, and results in shorter LOS and reduced intra-hospital transfers.  The biggest change with this new care process is caring for a broader range of patient acuity in general care units (in...

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