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PED-EM-L  February 2013

PED-EM-L February 2013

Subject:

Re: Transfers to and from other Hospitals

From:

Marty Herman <[log in to unmask]>

Reply-To:

Marty Herman <[log in to unmask]>

Date:

Mon, 25 Feb 2013 10:01:41 -0600

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (117 lines)

Biggest concern I have with tihs discussion is that the ED can't house the patients till floor , hall or closet beds open up. SO unless the Administration has a surge plan or some contingency plan to accomodate the over flow, like cancelling elective surgeries and using the PACU to house sick patients, or opening seasonalunits, or using hallways , closets etc to get the kids out of the ED< then I would defer accepting transfers.. The ED has to remain open, to handle the acute and potentially devastating problems that will come in the ED doors.
 
Think about it, an ER with 40 beds who are holding 10 patients, has reduced it's capacity by 25 %. Not oo mention the nursing is not staffed to care for inpatients in addition to the ED patients. SO housing patients just "gum" up the works and shreds the emergency net for those patients who really need us..


Marty
Martin Herman, M.D.
Pediatric Emergency Medicine
Sacred Heart Children's Hospital
Florida State University, Department of Pediatrics
5153 N. 9th Ave, 6th Floor Nemours Bldg
Pensacola, FL 32504
Ph: 850 416 7658(office)
Email: [log in to unmask]
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> Date: Mon, 25 Feb 2013 00:45:18 +0000
> From: [log in to unmask]
> Subject: Re: Transfers to and from other Hospitals
> To: [log in to unmask]
>
> I have to agree with Halim, we need to think long and hard before refusing sick pediatric patients especially if we are the only show in town.
>
> This is obviously dependent upon what your local pediatric geography looks like but some patients may be better served in your tertiary pediatric hallway with the appropriate pediatric care and specialists than in the nicest suite in an adult hospital.
>
>
>
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Halim Hennes
> Sent: Saturday, February 23, 2013 7:54 PM
> To: [log in to unmask]
> Subject: Re: Transfers to and from other Hospitals
>
> I think we all need to take a closer and more objective look at the issue before we make such statements. If you are the only pediatric tertiary care facility in the region and/or the only level one pediatric trauma center is not an option that can better serve children in your region other than you. Over crowding and no beds is a common scenario. We need to be more creative and partner with hospital administrators, inpatient and ICU colleagues to develop a viable process that help you accommodate these transfer requests. We were very successful accomplishing this in Dallas. Happy to speak with anyone who is interested. Best regards
>
>
> Halim Hennes
> Sent from my iPhone
>
> On Feb 23, 2013, at 6:14 PM, "Soglin, David" <[log in to unmask]> wrote:
>
> > I also agree. The point of a transfer is to increase the level of care the patient receives because the transferring hospital does not have the facilities or skill set to provide an appropriate level of care. The truth of the matter is that when you are full, you also don't have the facilities to provide optimal care for the patient. All of our formal transfer agreements specifically state that we will accept their transfers when we can and having no beds is a reason to turn them down. If it is a hospital at we work with closely and often, we will assist them in finding another institution for the patient.
> >
> > David F. Soglin, M.D.
> > Chair, Department of Pediatrics
> > Cook County Health and Hospitals System Stroger Hospital of Cook
> > County (Cook County Hospital)
> >
> >
> >
> > On Feb 23, 2013, at 15:12, "Mike Falk" <[log in to unmask]> wrote:
> >
> >> Strongly agree with James on this: full is full! How can you reasonably care for a sick patient when you can't actually provide a space for them? Even then, overcrowding becomes dangerous and we do it during disasters and times of crisis because we have NO other option.
> >> Mike Falk
> >>
> >> Sent from my iPhone
> >>
> >> On Feb 23, 2013, at 2:52 PM, james reingold <[log in to unmask]> wrote:
> >>
> >>> If you have no capacity (beds) to care for the patient you are under
> >>> no obligation to accept and probably shouldn't unless there are
> >>> major extenuating circumstances
> >>>
> >>> James
> >>>
> >>> Sent from my iPhone
> >>>
> >>> On Feb 23, 2013, at 12:34 PM, "Julia Whitefield" <[log in to unmask]> wrote:
> >>>
> >>>> Dear Colleagues:
> >>>> In your hospitals, how has your administration or you as these administrators of your departments/divisions handled accepting transfers when your hospitals are full? And here I mean NO beds on the regular pediatric floors (incl. subspecialty floors), NO room in observation units, NO rooms in PICU and NO rooms in your EDs where you end up putting patients into the hallway, which is now full also.
> >>>>
> >>>> Do you accept them all anyway or if you have declined transfer? And if you have declined transfer, how has your administration handled this for the future?
> >>>>
> >>>> I would so welcome your feedback and would appreciate your answers directly to my e-mail address.
> >>>> Thank you -
> >>>>
> >>>> Julia
> >>>> Julia Whitefield MD, Ph.D.
> >>>> Albuquerque
> >>>>
> >>>> For more information, send mail to [log in to unmask] with
> >>>> the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> >>>> http://listserv.brown.edu/ped-em-l.html
> >>>
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> >>> http://listserv.brown.edu/ped-em-l.html
> >>
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> >>
> >
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