Thursday, June 4, 2009

Comptroller Wants Aid for Crowded Hospitals by John Blau - Queens Chronicle

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Queens emergency rooms, already crowded following two recent hospital closures, are now “in crisis,” according to city Comptroller William Thompson Jr.

Based on a policy alert he released to coincide with a press conference Monday at Jamaica Hospital Medical Center, Thompson said Queens medical facilities do not have enough beds to meet demand, patients are waiting longer to receive care and ambulance response times are slowing in the wake of closures at St. John’s Hospital in Elmhurst and Mary Immaculate Hospital in Jamaica.

Swine flu has tested the current system’s limits even more, as concerned citizens are rushing to emergency rooms to be tested for the illness. With an influx of H1N1-related visits, the comptroller’s report said Jamaica Hospital’s ER is seeing more than 500 patients a day.

The ER had been crammed before the outbreak, handling 350 patients or more on each of 20 days from mid-February through the end of March, as opposed to only two days during the same time period in 2008. Flu fears have only worsened the situation.

“Clearly, these efforts and conditions cannot be sustained,” Thompson said.

Joined by Borough President Helen Marshall, Thompson called on the state to offer more funding to Queens hospitals. He asked for loans to be provided to medical facilities that, in the midst of a recession, may not have the necessary funds to expand its surge capacity or hire more staff. In addition, Thompson seeks immediate aid for Queens, reminiscent of the sort sent to an area struck by a flood or fire.

Thompson, who is running for mayor, also criticized Mayor Michael Bloomberg for what he called “his silence” in regard to the hospital crisis. He then reminded the public of his own letter to the New York State health commissioner shortly before the two Queens hospitals closed Feb. 14. In the letter, Thompson said he warned of the stress the medical center shutdowns would have on emergency care.

As of now, Thompson recommends that individuals with flu symptoms be directed to ambulatory care facilities as a way of reducing emergency room traffic.

“I don’t know if it’s a question of approval [for funds] as much as we need coordination right now from both the city and state to provide the leadership to pull these things together,” Thompson said. “It’s about making the commitment at both the city and state level to make sure people are taken care of.”

Caritas Health Care Inc., which owned both hospitals, was allowed to fall into bankruptcy, and the two hospitals closed without required approval of a closure plan from the defunct company, according to Thompson’s report. From the “final draft” of Caritas’ plan dated Feb. 5, the city’s two Health and Hospitals Corp. facilities in Queens, Elmhurst Hospital Center and Queens Hospital Center in Jamaica, needed to take on an estimated 30,000 more emergency visits a year and 8,000 additional inpatient admissions. Caritas admits “these hospitals may not be in a position to absorb this projected demand in the timeframe contemplated.”

According to a 2006 report by the Borough President’s Office, Queens had 1.4 hospital beds per 1,000 residents. Manhattan, on the other hand, has 7.1 beds per 1,000 residents. Thompson’s report documents cases at Flushing Hospital and Queens Hospital Center in which doctors were given temporary permission by administrators to admit patients and have them wait in corridors up to 48 hours. Blood transfusions have been moved at times into hallways, as well.

A “living nightmare” was how one veteran doctor described conditions at Queens Hospital Center’s emergency room to the comptroller’s staff.

“The people deserve better,” Thompson said. “Our doctors, nurses and medical professionals deserve better. Our city, and the borough of Queens, deserves better.”

Marshall said she warned Gov. David Paterson around the time of the two hospital closures — long before the swine flu outbreak — that the borough would not be able to handle a major medical emergency. Queens, she said, has always been “under-bedded,” even when St. John’s and Mary Immaculate hospitals were in operation.

Visiting the remaining care facilities, such as Jamaica Hospital, Marshall said she has witnessed significant overcrowding, with patients in the hallways and nurses working 13- to 14-hour shifts. Often times, burn victims are transported to Manhattan.

“We need more beds, not less,” Marshall said. “Really and truly, we need help.”