Wall Street Journal: ERs Fill Up Downtown

Thomas K. Duane

June 25, 2010

Emergency rooms in downtown Manhattan have become more crowded since St. Vincent's Hospital closed in April, but ambulances are getting patients into the remaining ERs faster than they did when the 161-year-old Greenwich Village hospital was open.

The four downtown ERs left to pick up the slack—Bellevue Hospital Center, Beth Israel Medical Center, New York Downtown Hospital and New York University Langone Medical Center—have seen spikes in visits in May between 11% and 29% over 2008. ERs were unusually crowded in May 2009 because of the swine-flu scare, but visits rose slightly this May at all but Downtown's emergency room.

Although St. Vincent's treated 60,000 ER patients a year, city fire officials say the average time to take someone to a lower Manhattan ER is 6.5 minutes, 13 seconds faster than in May 2009.

Emergency medical technicians, working with hospital personnel, have shrunk by three minutes the time they spend handing off patients to hospital staff before they're ready for their next call, said Steve Ritea, a spokesman for the Fire Department.

And hospitals have been more flexible in dealing with crowded ERs. Downtown, for instance, pulls nurses from inpatient floors when more help is needed.

But state Sen. Tom Duane, a Democrat who lives in Chelsea, said he's concerned about the crowding at area ERs.

"We don't know the outcomes of people who actually need emergency care, who have to go a longer distance to get that emergency care," said Mr. Duane, who favors having a hospital with emergency care in the West Village again. "It would be better to have emergency care accessible 24/7 as close to where people in the lower West Side live and work."

The increase in emergency patients can have a ripple effect. At New York Downtown, just east of City Hall, the number of emergency surgeries has increased. That has prompted the hospital to move elective procedures later in the day, with some operations taking place at 8 p.m. or later. Soon, some elective surgeries will be scheduled for Saturdays.

For Beth Israel, the increase in ER traffic comes at an awkward time. The East 16th Street hospital is renovating its emergency department, with roughly half the space currently unusable. That has forced the doctors, residents, nurses and emergency workers to use every nook of floor and hall space to stash gurneys, doctors say.

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