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'Dangerously' overcrowded conditions persist at L.A. County-USC Medical Center's emergency room

November 9, 2010 |  2:00 pm

Average times patients wait to be seen at County-USC Medical Center's emergency department. Click to read the county's report. Overcrowding remains a persistent problem at Los Angeles County-USC Medical Center’s emergency room even as conditions deemed dangerous have eased the last two months, county officials said Tuesday.

"Dangerously" overcrowded conditions in the 600-bed hospital's emergency room declined in September and October over August, when dangerous overcrowding existed for about 16 hours each day, county health officials told supervisors Tuesday.

Carol Meyer, the county health department’s chief network officer, credited organizational changes in the emergency room with reducing overcrowding and wait times.

“We are definitely making improvements in the crowding level based on some of the rapid medical evaluation changes that we have been making and the availability to more rapidly see our patients within 60 minutes for a medical screening examination,” Meyer said.

But even with the reduction, the hospital east of downtown was still “dangerously” overcrowded more than 12 hours a day in September, according to a report Meyer presented to supervisors Tuesday. In August, the emergency room was “dangerously” overcrowded about 16 hours day, twice as much as in July and four times the rate in June.

Federal officials had threatened to cut the hospital’s Medicare funding after a May inspection showed overcrowding delayed at least two patient’s care in the emergency room, leading one to leave without being seen by medical staff.

During the last two months, County-USC staff reduced the number of people who left the emergency room without being seen by half, serving 400 more patients a month, according to Tuesday’s report.

“We are using all of our acute care beds very efficiently,” Pete Delgado, the hospital’s chief executive, told supervisors.

But Supervisor Gloria Molina, whose district includes the hospital, said she was still unsatisfied with crowding levels and possible liability.

“You still have a very dangerous overcrowding situation and you still have a wait time that is outrageous,” Molina said, calling the hospital “a potential powder keg.”

She questioned why county health officials had not negotiated agreements as promised with additional private hospitals to accept transfer patients. Last month, supervisors more than doubled the amount the county pays private hospitals to accept transfer patients from County-USC from $2 million to $5 million.

Meyer said officials had attempted to negotiate transfer contracts with two hospital systems in recent weeks, but they balked. Officials at two additional hospital systems have expressed interest, she said, and county health officials expect a decision from them within the next two weeks.

Molina and Supervisor Mark Ridley-Thomas have requested a study of what it would take to add 150 more beds to the hospital, which the county rebuilt with 220 fewer inpatient beds two years ago against Molina's advice.

“Overcrowding is dangerous and it shouldn’t be happening at a brand new facility,” Molina said.

-- Molly Hennessy-Fiske

Image: Average times patients wait to be seen at County-USC Medical Center's emergency department. An average wait is measured as the time between when a patient is triaged and when the patient is either discharged or admitted. Credit: Los Angeles County