We know the flu thing is likely to get worse, which means a lot more ER visits.
As I have seen so far, we are more a part of the problem than the solution. Even when people call to ask if they should come in, we can't give them consistent accurate advice. Our docs are all over the place regarding who gets swabbed, and who gets Tamiflu. Most get at least fluid and Zofran, re-enforcing the belief that the ER is the place to go if you think you might have the flu.
Our ILI visits fall into 3 categories:
People who have the flu and might benefit from Tamiflu. A small minority.
People who have the flu and won't benefit from Tamiflu.
People who are sick, but don't have the flu.
This last category is probably the majority- people with compromised immune systems. They spend hours in a poorly ventilated waiting room and an ER. Every surface is coated with god knows what, people are coughing and hacking. Other than actually sucking on used flu swabs, I can't think of a better way to get the flu than to come to the ER. We make half hearted attempts with gowns and masks on occasion, but ignore basic hygiene.
In addition, there is the general crowd of ER patients, many, (if not most) are not acutely ill, but tend to be unhealthy in general They are also being exposed.
We have no plan in place to deal with this. There has been no change in staffing models. There has been no change in flow. We will continue to use the same cumbersome system. I will still need to ask a bunch of questions that A- have no bearing on treatment, and B- people lie about. I will still need to do redundant charting etc...All the things I currently waste time doing. Except I will be doing it in the middle of an epidemic. Or pandemic. Or whatever might be on its way.
Assuming this continues to grow, both in reality and public perception, we are hosed. I wish I could say it is unbelievable how unprepared we re, but it is unfortunately completely believable.
Anybody doing a good job preparing and dealing with flu this year?
