Back in 2009, Stuart Kohn of North Laurel, noticed that the wait times in the Howard County General Hospital (HCGH) emergency room were extremely long. In fact, the hospital was often on yellow alert. When a hospital is on yellow alert emergency responders are advised to take patients to less crowded facilities because the emergency department (ED) has temporarily requested that it receive absolutely no patients in need of urgent medical care. This can potentially result in compromised care.
Stuart met with the HCCA Board and advised them of issue. The Board agreed to pursue the matter and an HCCA committee was formed with the goal of reducing yellow alerts and shortening the length of emergency room visits. The committee contacted key personnel at the hospital as well as within the county Health Department to alert them to their concerns. These key officials agreed to meet with the HCCA in order to review their concerns and to put together an action plan to address them. Over a period of about a year, the HCCA committee met with key personnel to identify the driving factors behind the long wait times and yellow alerts and to put together an action plan to address them.
Ultimately, the hospital took a multi-pronged approach to solving the problem which included adding more hospital beds and implementing new procedures for moving patients waiting for hospital beds out of the ER more quickly — thereby making room to accommodate new ED arrivals. Additionally, community education around when to use the emergency room was identified as a key factor in reducing the long wait times. To this end the HCCA held a community forum that provided information about when to use the ED versus an urgent care facility as well as providing information about alternate options for obtaining medical advice. In addition, information about local urgent care facilities was posted on the county government website as well as the HCCA website.
The committee sites “raising the issue” as well as “getting the involvement of key hospital and county personnel who could impact the process” as two of the key reasons for achieving a successful outcome on this project. Additionally, the committee was prepared and well versed on the issues prior to contacting the decision makers which enhanced credibility with the organizations.
For additional information, this provides a link to the reports the HCCA committee submitted on this initiative as well as a link to a chart showing the yellow alert statistics for Howard County from 2008 through 2012. This chart illustrates the significant drop in the occurrence of yellow alerts, from a high of 24% of calendar days in 2009 to 3% in 2012.