Friday, January 17, 2014
F grade in national report underlines Hawaii’s lack of disaster readiness—it’s time to fix the problem
“The admirable commitment that Hawaii's state government shows to public health needs to be shown in other areas that affect emergency patients," Dr. Jay Ishida, president of the Hawaii Chapter of ACEP, said in a news release. "Hawaii's gaps in hospital and treatment facility capacity lead to overcrowding, long wait times and an inability to respond to disasters. The best medical care in the world won't help you if you can't get to it in a timely manner.”--Isles fail to make the grade in hospital capacity, ER access, Star-Advertiser 1/17/2014 p. B1
by Larry Geller
The other day I watched from the window as an ambulance tried to make progress through a completely stopped H-1 traffic jam, its siren wailing with desperation. Eventually it made it through. I hoped it would have been in time.
Oahu continues to suffer from the closure of hospital ER facilities. Ambulance diversions from overcrowded hospital emergency rooms demonstrate that the problem is ongoing. Since the closing of two Hawaii Medical Center hospitals, patients in Central Oahu need to fight that traffic to reach overcrowded and inadequate hospital facilities in town.
In a report released yesterday, America’s Emergency Care Environment, Hawaii was ranked 44th in the country in Access to Emergency Care and 41st in the country in Disaster Preparedness by the American College of Emergency Physicians. Both of these rankings earned Hawaii a grade of “F” on the organizations Report Card.
Where have you read about this before? Who has repeatedly sounded the alarm about Oahu’s vulnerability in case of natural or other disaster??
- Jan. 8, 2012: Does Oahu have enough emergency room capacity for a real emergency?
- Mar. 15, 2012: Oahu likely in denial about hospital crisis—what if we have a real emergency?
- Nov. 2, 2012: If Sandy had hit Honolulu, would our hospitals have been ready?
- Sept. 13, 2013: Honolulu can choose its Apolcalypse (ER pocalypse)
In an older report, following Hawaii’s C- ranking by the same organization in 2006, I wrote:
- Jan. 10, 2006: Hawaii's medical infrastructure deteriorating, unready for disasters
- Jan. 15, 2006: Update: Lights out in the ER--Hawaii's deteriorating medical infrastructure
Since the closure of the two Hawaii Medical Center hospitals, emergency rooms have been filled to capacity and ambulances diverted enroute. Until Queens opens its facility in Central Oahu, no relief is in sight. Had a hurricane hit, or if a disaster should befall this island before the Queens facility is opened, would we be content to stack patients or bodies in hospital hallways due to lack of capacity?
The Star-Advertiser hid the Report Card story in the Money section of today’s paper, and reported only a dim bright spot:
"When HMC shut down it generated an immediate crisis in ER availability," [Toby] Clairmont [, director of emergency services for the Healthcare Association of Hawaii] said. "We've compensated for it a little bit.
That’s good to hear (a little bit). Clairmont is perhaps the most knowledgeable person in the state on Hawaii’s healthcare preparedness. He did not respond to a Dec 28, 2011 email I sent asking for comment on the ER shortage created by the hospital closures. In fact, it was frustrating that no expert I tried to reach out to would comment on whether Oahu was at risk and what could be done about it.
The City Council held a hearing last year at which I testified. A group of doctors told lawmakers at that hearing that they were ready to provide services given a facility, but the Queens Hospital representative stated (paraphrase) that no facility would be available until the hospital reconstruction would be complete, set for 2014. At the same hearing, it was noted that Tripler had stepped forward to accept emergency patients.
After the meeting I spoke to the Tripler representatives about the possibility of setting up outdoor or temporary medical facilities, if not right then, at least in an emergency (which requires prior arrangements and planning). Remember M*A*S*H? It appeared that emergency physicians were available but had no place to treat patients. But nothing came of that idea.
Indeed, if nothing but “a little bit” has been done, the ACEP report should be a message to state and county lawmakers that we are at risk.
And that they need to address the problem and work to better our grades.