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Hospitals were last night accused of keeping thousands of seriously ill patients in ambulance 'holding patterns' outside accident and emergency units to meet a government pledge that all patients are treated within four hours of admission.
Those affected by 'patient stacking' include people with broken limbs or those suffering fits or breathing problems. An Observer investigation has also found that some wait for up to five hours in ambulances because A&E units have refused to admit them until they can guarantee to treat them within the time limit. Apart from the danger posed to patients, the detaining of ambulances means vehicles and trained crew are not available to answer new 999 calls because they are being kept on hospital sites.
Advances in Medical Technology: Stationary Ambulances
The British government has set a targeted turnaround time of four hours from arrival in an emergency room to treatment by a medical professional. Demanding that hospitals meet a desired target may not seem like a brilliant way of addressing scarcity, but a public sector union say the hospitals have managed to find a solution: Make patients wait outside the emergency room.
Comments to "Advances in Medical Technology: Stationary Ambulances":
Then it's settled. We don't want a system like the Brits have.
sage | February 21, 2008, 5:09pm | #
Next they will not allow the "holding pattern." So what's next? Well, they just have to make sure the patient is seen by a "medical professional." Notice that "doctor" or "nurse" is not specified. Hey, I worked housekeeping in a hospital in Anchorage; I was a "medical professional" at the time."Here, put some of this ice on that. I'm gonna go 'back one out.'"
Please, someone show up and defend socialized medicine. Utter delusion entertains me. Oh, the excuse "they are just doing it wrong" doesn't fly.
What must really suck for those patients is knowing that once you get dumped out of the ambulance and into the ER it's another four hours before someone will even look at you.
The Kaiser Hospital I go to built a new emergency entrance that is accessible by vehicle only, an Urgent Care Clinic was added next door.
Maybe they're just trying to mimic the dental system over there.
J sub D | February 21, 2008, 5:34pm | #
The British government has set a targeted turnaround time of four hours from arrival in an emergency room to treatment by a medical professional.Funny, here in Motown I've seen billboards and TV ads for hospitals guaranteeing that you will be seen by a doctor in 30 minutes or less in the ER.
anon | February 21, 2008, 5:36pm | #
Episiarch,Have you been to an ER room in the US lately? I have and I almost left before the doctor decided to see me.
bigbigslacker | February 21, 2008, 5:52pm | #
anon,Last time I took my son to my buddy's house to ride the 3-wheeler and shoot guns (.410, 12 ga, 7.62 x 39, 9mm, the works) the total time at the emergency room was under an hour. I'll shoot him again if he keeps falling off the trike.
joshua corning | February 21, 2008, 6:11pm | #
This works in land use...in Washington state they have like 120 days to either approve or deny a land use application.So what planners do is continue to deny the application as complete until they have time to meet that dead line.
It is really sad that now government employees use those same methods when peoples lives and health are at immediate risk.
Dave B. | February 21, 2008, 6:12pm | #
US emergency rooms can be pretty bad sometimes. But I've never heard of someone having to wait outside for 5 hours before being allowed to come inside for a 4-hour wait. Last time I had to go to the emergency room, my girlfriend had sprained her foot and we thought it might be broken. Fairly minor injury, had to wait maybe an hour. This wait seemed interminable. I can't imagine having to wait over 4 hours with a more serious injury.Sam Grove | February 21, 2008, 6:14pm | #
Have you been to an ER room in the US lately?Well, last year, before we adopted Alexis, she bit the dog's tail while he was lying on the floor. He raked her and left a gash.
Went to the emergency room at the COUNTY hospital.
Six hours it took before treatment. The gash had closed up and they had to reopen it for antiseptic treatment.
One of the best things about American adopting a single-payer/private care system of universal health coverage is that it would work so well that the Brits and the Canadians might be motivated to reform their own Flintstones-era systems along similar lines.
Rhywun | February 21, 2008, 11:48pm | #
Harrumph. When I broke my arm and wrist around 1990 in Buffalo, I had to wait eight hours for a doctor. At least I got a bed in the ER; but I couldn't sleep because they wouldn't give me enough drugs :)Ian | February 22, 2008, 2:44am | #
HMO's can be pretty bad but they don't line up ambulances so they don't look bad. I don't even think a socialist could defend this.I'm not saying there doing it wrong but they don't seem to have these problems in france, just riots and deficits.
Mad Max | February 22, 2008, 3:40am | #
"One of the best things about the adoption of a single payer/private provider health care system in this country will be that its success might motivate the British and Candadians to reform their Flintstone-era universal health systems along similar lines."OK, I must really be out of date. I was brought up as a good Socialist, under the doctrine that America needs to have national health health care like those other enlightened countries . . . countries like the UK.
Now the new line seems that America must adopt socialism in order to teach certain other socialist countries how to do it properly.
But if even the UK and Canada can't be relied on to do socialism right, why should we assume America could do it better?
technomist | February 22, 2008, 7:57am | #
So an accusation by a health services union, (which has a clear vested interest), published in the Guardian, about unnamed hospitals, relating to 'some' patients is taken as a 'fact' from which general principles can be deduced about the health system in the UK.This website/magazine is still called 'Reason' for a reason?
technomist | February 22, 2008, 8:14am | #
If ambulances with emergency patients really were sitting in carparks for an hour at a time on any scale before going in the A&E doors, it would not take a statistician or a union hack making a press statement for the public to find out about it - there would be very loud and vocal complaints by patients, relatives, nurses and doctors as well as the crews themselves.The reason this is not what is happening is that the abuse is not a practice involving the abuse of critical patients, but one relating to crews skulking about before admitting to their controllers that they actually finished the delivery task they were on and are now free to get back to work. It should be clear from the article that the alleged 'stacking' time is based on measuring a period of time which includes the time the ambulance crews spend after the delivery - time spent hovering around, drinking tea, posing in a macho manner in front of the nurses, and chatting with their colleagues. They are not watching people die in the carpark.
Jake Boone | February 22, 2008, 8:38am | #
This website/magazine is still called 'Reason' for a reason?Drink!
Episiarch | February 22, 2008, 8:54am | #
One of the best things about the adoption of a single payer/private provider health care system in this country will be that its success might motivate the British and Candadians to reform their Flintstone-era universal health systems along similar lines.HAHAHAHAHAHA
joe, I said that you can't use that line (maybe you were making a funny, that would be cool):
Oh, the excuse "they are just doing it wrong" doesn't fly.
If hospitals would set up after hours clinics for non-critical patients next to or near ERs, then the people in the waiting room with a cold could go there. These places often aren't covered by insurance because they charge differently than a doctor's office. All patients who feel their life or immediate health are in danger get covered in the ER. There should be some agreement with the insurance companies that the clinics will be paid less but with similar consistency as the ER. This would save the insurance company money (and their customers) since they wouldn't get an expensive ER bill, and patients would get seen quicker. Only question is, are there enough doctors. Close proximity would allow a rotation or flow of doctors if they need more help at the ER or vice versa. It won't stop people from going, but it would help with triage, wait times, and overall urgency of care.
R C Dean | February 22, 2008, 9:53am | #
Have you been to an ER room in the US lately? I have and I almost left before the doctor decided to see me.Most hospitals in the US have pretty good ER turnaround times. The ones that don't tend to be "last resort" hospitals that get used a lot for primary care.
Why do hospitals get used for primary care, you ask? Why do these hospitals have to use up their limited resources giving every crackhead who comes in with the sniffles a full work-up?
Why, federal regulation, of course. The Emergency Medical Treatment and Active Labor Act.
If hospitals would set up after hours clinics for non-critical patients next to or near ERs, then the people in the waiting room with a cold could go there.
Wouldn't help very much. EMTALA requires that everyone who presents to the hospital ER get a full emergency work-up. It also defines being on hospital property (including parking lots)as presenting to the ER.
HMOaner | February 22, 2008, 10:09am | #
Why do hospitals get used for primary care, you ask? Why do these hospitals have to use up their limited resources giving every crackhead who comes in with the sniffles a full work-up?Why, federal regulation, of course. The Emergency Medical Treatment and Active Labor Act.
That and the nice fat bill!
RC, that's my point exactly, they could roll them over to the clinic and still be in compliance or if there is wording that doesn't allow them to they could easily use their influence in government to add clinics as acceptable. Insurance companies, doctors, hospital administrators, and even patients should be on board with this. No one wants someone to die because they needed emergency care but someone with the sniffles was in their way. This is just common sense of which I believe requires a prescription.