Philadelphia Hospital Cited for ER Delays

By Walter F. Roche Jr.


By Walter F. Roche Jr.

Pennsylvania Health Department inspectors have cited Philadelphia's Saint Christopher's Hospital for Children for excessive delays in providing care to patients who came for emergency care.
In a report recently made public, the state found that one patient who showed up at 9:29 p.m. wasn't seen by a doctor until 1:16 a.m. the following day.
In fact the inspectors found that there were excessive delays for emergency room patients to get basic triage.
In the report dated June 6, the inspectors stated "it was determined that the facility failed to ensure prompt examination for 5 of 10 patients presenting at the emergency room for treatment.
Cited by the state was a requirement that hospitals with emergency departments "shall provide prompt examination or treatment, or both, to all persons who come or are brought into the hospital in need of such treatment, irrespective of ability to pay.
 "Such treatment shall be of the highest type consistent with the facilities available and with the standards established in the medical community of which the hospital is a part," the report adds.
Patients, inspectors found, waited from 40 minutes to an hour and 11 minutes before getting initial triage.
Some patients, they found, apparently gave up and left.
The waits to get actual treatment and be reassessed were even longer, with seven of 10 emergency room patients facing extensive delays. Those included the patient who didn't see a physician until 1:16 a.m. the next day.
 Officials of the hospital filed a plan of correction with the state in which it promised to take several steps to speed up the process. The plan includes increased monitoring of any backups and the assignment of additional nurses when needed.
Saint Christopher's spokeswoman Kelsey Jacobsen said the corrective action plan has been accepted by the state and "includes the methods by which the hospital will be measuring the effectiveness of our corrective actions."
 She said state inspectors have not yet shown up for a followup visit to the facility, which is part of the Tenet Healthcare Corp..
 The corrective action plan includes increased monitoring of any ER backups and the assignment of additional nurses when needed.
"If any patients are found to be waiting more than 10 minutes for a registered nurse assessment, an additional nurse (RN) with triage training will be deployed to the waiting area to perform an assessment of those patients and assign a preliminary acuity (ESI) level," the plan states.
Also included are new procedures to improve "patient flow."
The hospital promised to conduct audits of records to ensure that the problems were not repeated.
The inspection was based on a review of record of patients who showed up at the hospital's emergency room on the evening of May 2.
The report was completed on June 5, but, by standard department policy, was not released to the public until 41 days later.

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