急诊科 care teams ask for trust and patience to deal with capacity concerns

一篇由詹妮弗·V .撰写的观点文章. 教皇,医学博士

十大正规博彩网站评级正规博彩平台健康运营副主席, 急诊科, 医疗主任, 急诊科, Dartmouth Hitchcock Medical Center and 爱丽丝·派克纪念医院, 急诊医学助理教授, 十大正规博彩网站评级正规博彩平台大学盖泽尔医学院

在医疗保健方面，没有人喜欢等待. By definition, emergencies are serious, often dangerous situations requiring immediate action. For those of us caring for patients on the front lines of emergency departments, the escalating patient overcrowding crisis is an enormous challenge and frustrating issue—and for patients, 这是一颗难以下咽的药丸.

然而，改变的第一步是意识. 作为一个致力于提供高质量产品的人, safe and efficient emergency medicine at 十大正规博彩网站评级正规博彩平台卫生’s Dartmouth Hitchcock Medical Center (DHMC) and 爱丽丝·派克纪念医院, it’s important to be transparent with our patients while we work to resolve this mounting public health crisis.

甚至在大流行之前, long waits and patient overcrowding nationwide in emergency departments were a growing problem and now, 流行后, this escalating crisis is resulting in an all-too-common healthcare phenomenon known as boarding. “Boarding” is an industry term used to describe an unplanned delay in moving patients from the emergency department to the appropriate care setting because there is simply no available bed for them. 新罕布什尔州也不能幸免于这种公共卫生困境. In 2023, DHMC’s annual emergency department volume was the highest in history, 并且已经, 2024年有望超过这一水平. 和, 因为DHMC是新罕布什尔州最大的医院, 也是唯一的学术医疗中心和一级创伤中心, we are caring for an unprecedented volume of patients with very complex medical needs.

It is important to us that our patients and families know that we do not dismiss these emergency department waits as a mere inconvenience. 我们知道等待对病人和家属来说是多么有压力. With emergency departments facing unprecedented capacity challenges, 病人护理必须在同样前所未有的水平上进行分类. Our nursing partners are working incredibly hard to care for patients with emergent needs like strokes and heart attacks while also caring for patients with inpatient nursing needs. This puts a strain on every aspect of the delivery of emergency care. 这不是我们想要的提供医疗服务的方式.

虽然这是一个复杂的问题, 在最基本的层面上, 这种普遍的医疗功能失调是由于床位不足造成的. 和其他许多州一样, 在新罕布什尔州, we simply don’t have enough options to move existing patients out of the hospital beds they occupy and into skilled nursing or other long-term care facilities because those facilities are dealing with the same workforce challenges as we are. The lack of appropriate discharge options translates to emergency department backlogs where it’s not uncommon to find admitted patients waiting on stretchers in hallways for a room to open up. 可悲的是, 这个问题对老年人的影响尤为严重, 与精神疾病作斗争的人, 以及其他高危人群. Often, these individuals do not have access to primary care, or even basic transportation. 和, because emergency departments are open 24x7 and are required by law to treat and/or stabilize anyone, these populations often depend on emergency departments as their only source of medical intervention, 救护车是他们唯一的交通工具. 可悲的是, they may have no family or friends to advocate for them or help them to navigate complex decisions.

I went into the field of emergency medicine because I am dedicated to providing high-quality and efficient care to anyone in need. 在我职业生涯的近20年里，这种激情并没有消退. Our emergency teams are not only experts in their fields but also members of your communities. 我们是你的邻居. 我们非常关心你和你的健康需求. We are working harder than ever to triage and treat everyone who walks or rolls through our doors. During the pandemic you trusted us with your lives and your loved ones. We ask you to trust us again now as we navigate these unprecedented capacity challenges. 通过让你意识到这很复杂, 细微的问题, we hope a mutual understanding will foster continued confidence in our unyielding commitment to all patients.  我们请求你们的理解和耐心. Those in the healthcare system are working to resolve these capacity issues. 我们决心已定.