Gainesville ERs reflect state emergency care crisis as 10 percent more visit UF


Published: Friday, January 13, 2006 at 6:01 a.m.
Last Modified: Thursday, January 12, 2006 at 11:11 p.m.

Facts

Only 12 states ranked lower

How Florida ranked: Overall ranking: Out of 50 states, only 12 scored lower.
Top-ranked states: California, Massachusetts, Connecticut.
Lowest-ranking states: Arkansas, Idaho, Utah.
Overall grade: C-.

The state of Florida got its report card on the quality of its emergency medical care this week, and it couldn't even manage a C average.
The first national report card on the status of emergency medicine was issued by the American College of Emergency Physicians, and Florida received a C-. Only 12 states fared worse.
"Emergency care in this country is in crisis, and it's related to a number of factors," said Dr. David Seaberg of the University of Florida College of Medicine. Seaberg serves as chief of emergency services at Shands at UF, where the emergency department sees nearly 40,000 patients each year.
Seaberg says more people are visiting the emergency room each year. Numbers at Shands UF were up about 10 percent in 2005.
"The number of uninsured who don't have health care and are visiting the ER is on the rise," he said.
The ER doctor says he sees - and hears - the frustration of patients waiting hours in overcrowded emergency rooms. Often, he reports, a third of his beds in the emergency department are filled by patients who need to be hospitalized, but must wait to be admitted because of a shortage of available beds or nursing staff to care for them. Instead, they must be "boarded" in the ER.
"We are the only specialty that will take care of you without regard to your ability to pay," said Seaberg. "But the uninsured often wait until they are very sick before seeking care in the ED (emergency department)."
The American College of Emergency Physicians is a national group headquartered in Dallas and representing more than 23,000 physicians specializing in emergency medicine. Dr. Angela Gardner of the ACEP chaired the task force that put together the national report card.
When the study was released Tuesday, Gardner said, "The state of emergency care in this country is critical. If it were a patient, we'd be putting it in the ICU."
According to the ACEP report, 80 percent of the states have emergency departments plagued by overcrowding and long waits, increasingly limited access to care, soaring liability costs for doctors and an inability to deal with natural disasters or potential terrorist disasters.
"Outside of every hospital in this country is a big red sign that says 'Emergency,' " said Gardner. "Unless we fix the problems you see today, when you have your heart attack, that sign could say 'No vacancy.' "
A recent report issued by the Florida Hospital Association also concluded that the state's system of hospital emergency care is facing a crisis.
Alan Levine, secretary of Florida's Agency for Health Care Administration, maintains that the state has some of the country's best emergency care providers.
"I would dispute that our system rates a C-," he said. "Like all other states, we're struggling with the issue of emergency access."
Seaberg said UF's College of Medicine and Shands HealthCare are taking steps to improve the patient experience in the emergency department.
UF now trains 45 residents in emergency medicine at Shands Jacksonville. A new program starting in July will train eight more residents a year in Gainesville, adding a total of 24 to the three-year program. Medical liability reform passed by the Legislature in 2003 will help Florida keep the ER physicians trained here, in Seaberg's view. Shands will put an emergency department, double the size of the current ER, in the new hospital planned for a site across Archer Road. But that facility won't be up and running until 2009.
"Meanwhile, we expect to see our volume double in the next five years. And if we grade out at a C right now, what happens in the event of a disaster?" Seaberg said.
If that happens, we are in trouble." Diane Chun can be reached at (352) 374-5041 or chund@gvillesun.com

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