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Connecticut's emergency rooms are overcrowded — and lawmakers want to study the issue

A temporary structure has been in place for nearly two years to manage overcrowding at Yale New Haven Hospital and Yale New Haven Children’s Hospital.
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A temporary structure to manage overcrowding at Yale New Haven Hospital and Yale New Haven Children’s Hospital has been in place for nearly two years.

A temporary structure set up to manage overcrowding at emergency departments remains in place nearly two years later at Yale New Haven Hospital and Yale New Haven Children’s Hospital.

It’s a result of an overcrowding problem, and it’s affecting hospitals across Connecticut, physicians say.

Lawmakers on Wednesday discussed a bill that would address hospital overcrowding by establishing a working group to evaluate the matter.

Dr. Christopher Moore, an ER physician at Yale New Haven Hospital, testified in favor of SB 960 at a Public Health Committee hearing.

“We have 54 beds in our emergency department; we often have 70 patients boarding,” Moore told lawmakers. "So that means every single patient is pretty much seen in a hallway.”

Moore said that after doctors evaluate emergency patients and determine that they require in-patient hospital care, the patients continue to remain in the ER, backing up care for others.

He says patients are being seen in what he describes as a tent – hospital officials told Connecticut Public that it’s a temporary annex. The structure is approved on a six-month basis by the state Department of Public Health.

“We put up a tent in the parking lot of the pediatric emergency department at York Street, which is supposed to be temporary but looks very permanent,” Moore said. “And that’s where we’re seeing patients.”

The bill calls for the public health commissioner to convene a working group by July to advise the commissioner regarding methods to alleviate ER crowding and the “lack of available emergency department beds” in the state.

One major issue: Patients are entering emergency rooms with more severe complications.

Many patients require more care for longer periods of time, and health care staffing shortages compound the problem, according to the Connecticut Hospital Association, which testified in favor of the bill.

“EDs are often gridlocked with patients waiting to be seen by an ED clinician or specialist, waiting for admission to an inpatient bed in a hospital, or waiting to be transferred to a psychiatric, skilled nursing, or other facility,” said Paul Kidwell, CHA’s senior vice president of policy. “ED overcrowding is not a cause, but rather a symptom of current challenges and deficiencies in the health care continuum.”

Yale University researcherslast year published studies that documented a “widespread and increasing level” of overcrowding in emergency rooms across the United States. Overcrowding risks patient safety and access to care, researchers said. They described it as a crisis.

Moore emphasized that for the hospitals, it may be less expensive to have patients in the emergency department, where there are less stringent nurse-staffing ratios than those on the hospital floors.

“We often have beds available in the hospital that are not staffed, not cleaned, and that does back up the patients in the emergency department,” Moore said. “We now have a physician stationed in triage that sees all the patients in the waiting room as an initial evaluation, which is really just suboptimal care.”

Moore said it comes down to a misalignment of economic incentives at hospitals across the country.

State Sen. Saud Anwar, a physician and co-chair of the Public Health Committee, said committee members need to look into the issue.

“It is not only inconvenient for the patients, it is dangerous for the patients,” Anwar said. “Because it’s becoming dangerous for our citizens, we have a responsibility to address this.”

Sujata Srinivasan is Connecticut Public Radio’s senior health reporter. Prior to that, she was a senior producer for Where We Live, a newsroom editor, and from 2010-2014, a business reporter for the station.