A carefully reported account last Sunday by staff writer Mary Meehan detailed the long waits patients have at the University of Kentucky's new, state-of-the-art emergency room — waits that are the longest in Kentucky and far exceed the national average.
Patients are lined up on beds in the halls while friends and family perch on stools for hours on end.
The time between entering the ER and being settled in a hospital bed is 10 hours and 44 minutes at UK. The average among the nation's top hospitals — with whom UK wants to compete — is three hours and 37 minutes. At the University of Louisville Medical Center, Kentucky's other Level 1 trauma center, the wait is seven hours and five minutes.
UK blames the long delays on a dramatic increase in patients (from 30,000 to 70,000 patients since the ER opened in 2010), the fact that it treats very sick people and a lack of hospital beds.
However, individuals and organizations that study hospitals say creating a more efficient system could cut wait times without spending hundreds of millions of dollars on new beds. Kentuckians need to know that the hospital is taking this challenge seriously, even if it requires bringing in outside expertise or rethinking current operations.
For now UK is going full steam ahead on at least two fronts: recruiting more patients and pushing forward on building out the remaining medical tower at a cost of $763 million. Until that's complete — four to six years from now — "we will have to muddle through," Dr. Michael Karpf, UK's vice president for health affairs, told Meehan.
By all accounts, muddling through with delays like those at UK can easily create patient-safety problems and affect the quality of care, especially as the Affordable Care Act allows more people into the health-care system.
Avoiding that, experts say, is simple: Improve the flow of patients through the hospital to reduce bottlenecks and silos within the process to make better use of both staff and facilities. It's not a new idea in medical care, but the Joint Commission, an independent nonprofit that accredits and certifies more than 20,500 health care organizations, says it has been "grossly underused."
The reasons are many but they mostly boil down to the cultural challenges when huge, complex organizations are directed by people with medical, rather than management, backgrounds. Streamlining and efficiency raise hackles and are often seen as code words for reducing the quality of care.
But the results at hospitals that have worked with outside consultants to examine and improve their systems tell a different story: More patients are treated with better outcomes and profits increase.
The Boston Globe reported that Cincinnati Children's Hospital achieved efficiencies, without any new construction, that allowed it to treat as many more patients as if it had spent $100 million to add 100 rooms. That is a plan worth following.
UK HealthCare should not push for spending hundreds of millions on more rooms without making every effort to examine and improve the ER system that could put patients at risk.