Ever since St. Clare’s Hospital merged with Ellis Hospital on June 13, the Ellis emergency room has been overrun with patients, overwhelming its already-stretched resources, Ellis CEO James Connolly said.
Patients are now waiting an average of 4 to 6 hours, “and in some cases it has been longer, much longer,” Connolly said, acknowledging recent public complaints. “People have had extraordinarily long waits.”
Now he’s asking patients with minor injuries to go to the former St. Clare’s Hospital, renamed the Ellis Hospital McClellan Campus.
“We need to move as much volume to McClellan as possible,” he said.
Patients who would have taken themselves to St. Clare’s switched to Ellis as soon as the merger was announced, believing the St. Clare’s ER was closed or that they would get better care at the main campus, Connolly said.
“We had a surge of patients,” he said. “It just became a huge problem.”
Residents have been complaining loudly — sometimes describing daylong waits for serious emergencies. Connolly said they’re right to complain.
His goal is to have every patient admitted and treated or sent home within 3 1⁄2 hours. But that won’t happen for a long time at the Nott Street campus. The hospital simply doesn’t have enough beds for everyone, Connolly said.
That’s because the St. Clare’s inpatients have been moved to Ellis, taking up beds that would have been used by emergency room patients.
But the move has helped the former St. Clare’s ER, which is now significantly faster than Ellis. Connolly said most patients there are treated and released or admitted within two hours. Wait times are longer on weekends and at night, when patients with minor illnesses or injuries can’t go to their doctor’s office so they seek help in the emergency room.
Patients who do not need overnight care — patients with broken bones, for example — should go to St. Clare’s, Connolly said. Patients with serious medical emergencies should go to Ellis. However, Connolly said, patients who are in severe straits should simply get to whichever hospital is closer.
“If you’re not sure what’s wrong, you get to the nearest ER. You don’t want to fool around,” Connolly said. “We triage you. If you’re clutching your chest and turning all kinds of colors, you’ll be brought right in.”
A “fast track” ambulance system brings patients from St. Clare’s to Ellis for inpatient care after they have been stabilized.
At either hospital, laboratory test results should be available in 45 to 60 minutes, Connolly said.
NEW ER PLAN
In the long term, Connolly wants to reduce ER wait times by building a new emergency room more than twice the size of the current Ellis ER.
Plans are already under way, and he hopes to submit them to the state Department of Health by the end of the year. If approval is granted early next year, the ER could be open by the end of 2010 at the earliest.
Tentative plans call for it to be placed on Rosa Road, next to the current ER. But first the hospital needs to empty the two buildings there, which would be torn down to make space for the new emergency room. Those buildings are filled with offices and outpatient services, all of which will be moved to St. Clare’s.
But the new ER might not open for three to four years, Connolly said. The wait times need to be addressed now.
So Ellis has opened 25 beds for emergency room patients and hopes to open up another 35 to 40 by October.
Also, the hospital has added six new treatment areas to the ER, and another 11 will be open by the end of the summer. That will give Ellis 39 rooms — up from 22 originally — to cope with the increased demand.
Connolly said Ellis already has enough doctors and nurses to handle the patient load.
“I don’t think the staff is the problem. There aren’t enough rooms,” he said.
The emergency room was built to handle 20,000 patients a year. But long before the merger, it was handling 40,000 patients every year, with about 110 people walking through the doors each day.
As soon as the merger was announced in June, that average jumped to 124 patients a day. Wait times also skyrocketed.
Connolly’s doctors began meeting daily to try to address the situation. Eventually they put out the word to all paramedics and ambulance drivers, asking them to redirect their less-serious patients to St. Clare’s.
That has had an effect: in July, the daily patient load dropped to 118. But that’s still more than the ER can handle.
“We’re trying to bring that capacity on as fast as possible,” Connolly said. “Long-term, we need to build a new ER.”
If all goes well and a new ER opens in three years, Connolly wants to turn the St. Clare’s ER into an urgent care center that would not be open around the clock.
“But we’ll see how we do with managing the volume,” he said.
Ellis took over all hospitals in Schenectady County under orders from the Berger Commission, which set out a plan for health care consolidation throughout the state. The commission’s plan went into effect last year.
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