Emergency Room Overcrowding
The letter I wrote to Keith Steffen, adminstrator at OSF-SFMC, dated September 27, ‘01, described my thoughts and concerns about the OSF- ER after working an afternoon shift the day before. Elderly patientes signed out and went home because they just didn’t want to wait for a bed in the hospital to open up so they could be admitted. I felt very uneasy signing these sick people out of the ER to go home.
The Annals of Emergency Medicine headline an article in the January, 2000 issue “Overcrowding in the Nation’s Emergency Departments: Complex Causes and Disturbing Effects”. During the 90’s, overcrowding in emergency departments became a national issue. It didn’t just involve OSF in Peoria. The article stated, “ED overcrowding has multiple effects, including placing the patient at risk for poor outcome, prolonged pain and suffering of some patients, long patient waits, patient dissatsifaction, ambulance diversions in some cities, decreased physician productivity, increased frustration among medical staff, and violence….Unless the problem is solved in the near future, the general public may no longer be able to rely on ED’s for quality and timely emergency care, placing the people of this country at risk.”
In my opinion, this described OSF-ER almost perfectly. Thus, when I wrote Steffen my concerns and then met with him for the first time in early October, I had no idea that he would metaphorically refer to me in the meeting as a “cancer in the ER that needs to be cut out before it metastasizes” as well as a “hemorrhage that needs to be stopped before the bleeding gets out of control”. How his medical descriptions of me as a cancer and a hemorrhage related to bed capacity and overcrowding at OSF, remained a mystery to me. He didn’t seem to be focused on the important issues for OSF. He seemed to be focused on the concept of fear amongst employees and finding out from me which nurse started a petition in support of me and the problems I had addressed. And the ER director, George Hevesy, put me on probation for 6 months from working the ER the day after I sent this letter.
Almost a year after Steffen fired me from OSF, an article appeared in the journal “Academic Emergency Medicine”–The Elusive Nature of Quality. It discussed that systems need to change before emergency rooms can change for the better:
“Front line care providers (doctors working in the ER) are the frequent targets of criticism regarding the quality of care, and are often the recipients of the metrics we use to measure quality. These dedicated, skilled, and talented clinicians are often powerless when systems changes are needed, but they are held accountable for their actions within a SYSTEM THAT CANNOT ALLOW SUCCESS.
“The true route to achieving quality begins with an enduring commitment from the highest leaders of the organization, willing to exercise their authority for productive benefit. If the board of trustees and the CEO do not actively support excellence in the ED, enduring improvements are unlikely.
“If the messasge is not loud and clear that the patients in the ED must be served optimally by every service with impact, then mediocrity will be the norm. Responsibility must be properly allocated, which is a task of the leaders. No system is successfull without effective leadership.
“If we accept that the formula for quality begins with leadershhip, then the top of the hospital administration must set the expectations for all critical congributors to the ED.
“The essential element of leadership is strong principle.”
These paragraphs define the situation perfectly, in my opinion. However, Steffen and Hevesy must not believe in their validity based on their punitive actions against someone who pointed out to them the problem that needed their attention. And both Steffen and Hevesy told me that there were serious problems with leadership in the
On June 3, ‘05, a tiny article appeared in the Journal Star: “Peoria Hospital Opens New Emergency Unit”:
“OSF-SFMC opened its new $2.4 million Emergency Care Unit on Thursday. The 13-bed facility…will serve as an observation area for patients with chest pain, heart failure and asthma.
Mike Cruz, the assistant director of the OSF-ED stated, “It should help significantly…because of the operational components. This will increase total capacity (for emergencies) by about 30 percent. Given that we haven’t had a new facility recently and there has been a volume increase…it will help”.
Notice that it wasn’t Hevesy or Steffen that made this announcement to the public. This needed to happen years before and “the main campus (downtown OSF) had been ignored” according to Dr. Tim Miller in OSF administration when I met with him in September, 2001, after I had written my letter to Steffen.
In April, 2006 when OSF announced its new 234 million dollar campus renovation, Keith Steffen stated that this would include a "much needed" improvement in the Emergency Room which was built for 32,000 patients but is currently expected to have 62,000 visits in 2006.
Why did Mr. Steffen refer to me as a "cancer in the Emergency Department" when I brought the OSF bed capacity problem to his attention in 2001?
OSF’s leadership definitely is lacking, not based on strong principle, and needs a change.
It is October 17, 2011.
I posted this today.
Hope you are well.
Today is December 6, 2012.
Hope you are all ok.
This article is from Annals of Emergency Medicine 2012 and regards how ED overcrowding contributes to patient mortality.
I hope you have a good Christmas and healthy New Year.
- October (1)
- July (1)
- Introduction--Peoria's Medical Mafia
- Keith's Letter
- Conversations with Keith Steffen
- Keith Steffen and the Apostolic Christian Communit...
- Conversations with George
- Conflict of Interest
- OSF-AMT Relationship
- Emergency Room Overcrowding
- OSF Emergency Room Patient Satsifaction
- Fear at OSF
- Conversation with Sister Canisia
- Conversations in Church
- Sister Judith Ann
- Conversations With Chris
- Ethics Committee at OSF
- Ethical and Religious Directives for Catholic Heal...
- Patricia Gibson and Monsignor Rohlfs
- Picketing OSF
- Bishop Jenky Haitian Hearts Meeting---February, 20...
- Bishop Jenky's Threat
- Catholic Diocese Abandons Haitian Hearts
- Tom Carroll's Letter to Bishop Jenky---September, ...
- Bishop Jenky Rejects Catholic Tribunal Court
- Bishop Jenky's Response to Tribunal---November 17,...
- Paul Kramer--Executive Director Children's Hospita...
- OSF Cuts Haitian Hearts Funding--July, 2002
- Slow Down Surgery--Part I
- Slow Down Surgery--Part II
- Letter Regarding Delay of Surgery---November, 2002...
- Perfume, Pets, and Pediatrics
- Linda Arnold--OSF Foundation
- Letter to Illinois Attorney General---January 15, ...
- Willie's Pacemaker
- Jackson is Dying
- Joe Piccione---Ethics vs. Practice
- Diane's Letter to Joe Piccione and Patricia Gibson...
- Pleading OSF for Jackson's Life
- Letter to Sister, Keith, and Paul re: Jackson Jean...
- Jackson Jean-Baptiste Forum Article
- Jackson's Letter to Sister Judith Ann
- Washing Jackson's Feet
- Jackson Jean-Baptiste's Obituary
- Children's Hospital of Illinois Advisory Board
- Jackson Jean-Baptiste and Keith Steffen
- Jackson Shouldn't Have Died
- Emergency Medical Systems Failure in Peoria
- Peoria Journal Star Articles
- Firehouse Forum
- Cardiac Arrest
- Basic Drugs
- More Fear
- Trust in Physicians
- Questions for George, Rick, and Andrew
- On the Take
- Open Letter to Peoria Medical Society---January 6,...
- Questions About Matrix Consulting Group
- The Matrix Report
- Should Peoria Fire Department Sell Its Only Amubla...
- Let Peoria Fire Department Operate its Ambulance
- 19 Minutes Is Too Long
- Ambulance Monopoly Unhealthy for City
- Peoria City Council--August 9, 2005
- Peoria's Greed
- Peoria City Council---February 7, 2006