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Population Spike Strains BR Health-Care System *** Hospitals Say They're Running Out of "Wiggle Room"

Posted on: Monday, 20 March 2006, 09:01 CST

By MARSHA SHULER

Baton Rouge's general-acute-care hospitals are bursting at the seams since Hurricane Katrina hit in late August.

The influx of patients won't die down anytime soon, hospital officials say.

Some days patients stack up in emergency rooms waiting for a bed to become available in an intensive care unit.

Sometimes the problem is the availability of general hospital beds.

Patients trying to schedule elective surgery at times have to wait longer than they did before the storm - pushed down the list in favor of patients needing immediate care.

All the general hospitals have seen a big jump in the number of uninsured patients that look to them for care, straining the facilities' budgets.

"The number of individuals in the community is going to stay up. We__really have to have a focus on how we can handle that capacity," said Beryl Ramsey, chief executive officer at Summit Hospital.

"It will be a continued strain," he said.

People in the hospital industry talk about a hospital's "surge capacity," said Dr. Chapman Lee, medical director of LSU's Earl K. Long Medical Center. "We don't have any more wiggle room."

The situation could be much worse, hospital officials say.

"It's a good thing we didn't have a bad flu season or a cold winter," events that always push up hospital visits, said Our Lady of the Lake Regional Medical Center chief executive officer Bob Davidge.

Patient counts spiked at Baton Rouge General Medical Center's two campuses - Mid-city and Bluebonnet - in the wake of Katrina.

Chief nursing officer Deb Charnley said the patient load has settled down a bit. But some days it takes time to find an open bed, she said.

When Hurricane Katrina devastated the New Orleans area, the population of Baton Rouge and its surrounding parishes swelled, and the demands on the health-care system grew with it.

"It's a reflection of the additional people living in the area right now," said Louisiana Hospital Association president John Matessino.

"It's not just Baton Rouge. We are getting the same kind of reports out of Lafayette, and down around Houma-Thibodaux," he said.

No one knows yet whether the population shift is permanent and what additional hospital capacity may be needed, if any, Matessino said.

"It's a roll of the dice right now," he said.

At Woman's Hospital - a large specialty hospital - more pregnant women show up with unscheduled deliveries. That's adding hours to normal daytime delivery hours, said spokeswoman Jodi Conachen.

"We're delivering more babies," Conachen said. She said there's a constant ebb and flow of patients. "We are managing it," she said.

At Earl K. Long, Baton Rouge's charity hospital, the in-patient count has grown from 80 to 160 a day, said Lee. The number of surgical procedures increased 35 to 40 percent - about 100 extra cases a month, he said.

Lee said emergency room beds fill up because of the wait time to get patients admitted to the Airline Drive hospital or to make arrangements for people with mental health problems.

In the past, mental health patients were sent to Greenwell Springs Hospital, but "it's almost universally full," Lee said.

"There's a limit not just on bed space but personnel to take care of these people, from clerks to RNs (registered nurses)," Lee said.

Lee said the high number of uninsured patients will continue because under federal law they cannot be turned away.

Ramsey said Summit Hospital, located near Interstate 12 on O'Neal Lane, has seen its daily patient count rise up to 100 percent. The hospital has 140 to 150 beds, she said.

"After Katrina our volumes doubled, and we are still seeing a lot of that increase in the hospital, with so many folks coming to Baton Rouge," said Ramsey.

"It can be a little more challenging to get the services they need," said Ramsey.

"I think we need to sit down together - all the hospitals and come up with some solutions as a community how to handle it," Ramsey said.

OLOL's Davidge said the Essen Lane hospital has been very busy continuing into the new year.

"How much of this is Katrina, how much is the busy time of year, it's hard to tell," said Davidge. But Davidge said there's been no flu season - something that would send patient census soaring.

In January, Davidge said, there were 24 days over which the hospital chalked up almost 300 hours of diversion - meaning patients had to be sent to other hospitals. Typically, it was because the emergency room was full and no other beds were available.

"Sometimes you don't have an empty ICU bed or telemetry bed when you need it," Davidge said. "Then, there are psychiatric patients. That creates the bottleneck for emergency patients coming in."

"Some days we have patients waiting in the emergency department to get into an ICU bed or a hospital bed," the General's Charnley said.

When the General opens more beds at its Bluebonnet facility, the problem should ease, she said.

"It's going to be interesting to see how the summer months are going to flow," she said.

Source: Advocate; Baton Rouge, La.

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