Baltimore has so far been spared from the crisis of emergency room shortages sweeping the nation, but not because city facilities are any more efficiently run, a report released last week states.
“It helps that we have a lot of hospitals, but handling a mass casualty event would be an enormous challenge,” said City Health Commissioner Josh Sharfstein.
The city?s health care network is operating at its limits, according to a Baltimore City Task Force on Emergency Department Crowding report published June 9.
Between 2002 and 2005, ambulance trips to emergency rooms increased 8 percent, but time emergency medical technicians spent waiting for hospitals to accept their patients grew 45 percent.
Hospitals must begin treating patients more quickly and moving them out of their emergency departments, Sharfstein said. He called for more accountability from hospitals in regards to how long patients wait for care. He did not address other quality measures, such as how successfully hospitals treat specific illnesses.
The state must develop a more comprehensive plan for routing ambulances to hospitals that can accommodate them and for informing hospitals when ambulance crews are strained, he said.
City hospitals accommodate many of emergency room trips from surrounding counties.
On the other hand, the city has had two days so far this year where every hospital has gone into code red, said Dr. Bill Frohna of Union Memorial Hospital. This means their emergency rooms were full to capacity with no more cardiac-monitored beds.
“Baltimore City has experienced in the last several months, several days when all Emergency Medical Service units were on duty at one time,” he said. “At that point, if we get one more call, we would have to deny service or ask someone to wait for an ambulance.”
Baltimore has also had to recruit EMS units from surrounding counties to respond to city calls for service.
Other recommendations to relieve crowding in emergency rooms include developing separate facilities to handle drunks and people with chronic mental illness, increasing medical treatment of the poor and uninsured, and establishing case management for the chronically homeless population.
