Engineering a cure for hospital crowding and inefficiency

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    engineering a cure for hospital inefficiencies - philly.com

    12/30/11
    mark taylor

    for years, hospitals have responded to crowded emergency rooms and longer waits for beds by building ever-bigger buildings and spending vast sums - up to $2 million per bed.
    but expansion hasn't solved the problem, and the costs are becoming unsustainable. so some hospitals are trying a new tactic: working more efficiently around the clock.

    this month, the new jersey hospital association received a $7 million grant, in part to hire a former soviet industrial engineer whose forte is smoothing out the flow of hospital patients so they can be treated more efficiently....

    if adopted in all new jersey hospitals, he said, his methods could save at least $300 million and as much as $6 billion annually.

    litvak's challenge is immense. nationally, 91 percent of hospitals reported er overcrowding at least one day a week, according to a 2010 survey by the american college of emergency physicians.

    overcrowding has worsened in the last year, most hospitals have reported. nearly one-third said patient boarding - where patients are held in ers for hours at a time, usually because no beds are available - occurs from five to seven days a week.
    according to a report in july from the philadelphia-based delaware valley healthcare council, a hospital lobbying group, emergency visits in southeastern pennsylvania rose to 1.8 million in 2009, a 32 percent increase from 1998.

    the rise of uninsured patients is one factor. another is that ers are vanishing. while the number of er visits has soared from 90 million in 1990 to over 136 million in 2009, more ers have been closing. one-quarter of america's emergency departments have shut since 1991, including three in the philadelphia area since 2006.

    alfred sacchetti, who co-chairs the department of emergency medicine at our lady of lourdes medical center in camden, said that in the 1950s and 1960s, most hospital patients came through the front door. now he said, most arrive at all hours through the er, though many executives still run their facilities as monday-through-friday-based organizations....
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