Efforts this spring by local officials and the New York State Association of Nurses to draw attention to the issue of overcrowding at the Emergency Department of Weiler Hospital at the Montefiore Medical Center Einstein Campus in Morris Park were not ignored.
Recent changes to the emergency department have improved the situation, which was bogged down with excessive wait times and patients admitted to beds in the hallways, representatives from Montefiore Medical Center said.
Since this spring, Montefiore has taken steps to add beds, add staff, and improve the flow of patients, said Dr. Nadine Katz, a vice president at Montefiore and medical director of the Einstein Campus.
“We’ve made significant improvements, and we’re still doing work with them,” she said.
Improvements made
One of those changes was eliminating the traditional waiting room, so that patients are seen more quickly by a nurse and sent to the appropriate part of the emergency department to wait for treatment, said Dr. Deborah White, chief of services of the Department of Emergency Medicine, Einstein Division.
The new patient flow has decreased average wait times in the department, said White. Between September 2012 and September 2014, the average time between when a patient is greeted to when they see a doctor decreased from 2.5 hours to under 2 hours (although the time it takes for critical care patients suffering from a heart attack is a matter of minutes), the total length of stay for patients who will be treated and released decreased from 6 hours to 4.1 hours, and the time it took for patients to be admitted to a bed decreased from 17 hours to 15 hours.
“This is a huge improvement,” said White.
Montefiore also moved the orthopedic unit to a different campus earlier in the year, which created some additional space, said Katz, and is continuing to look into moving additional units this year to add more beds. The improvements meant that this summer, patients were no longer being admitted to hallway beds, said Katz.
One of the elected officials who pushed Montefiore to make improvements at the spring meeting, Assemblyman Michael Benedetto, said when he visited the hospital in July with other elected officials the situation seemed to have improved.
“I was quite impressed,” he said, of the new patient flow.
Not enough
But nurse Karine Raymond, NYSNA board member and chair of Weiler division, said that the changes are not enough.
“Things are minimally better,” she said about the situation.
The emergency department is still significantly overburdened, said Raymond, and the new patient flow has only changed where they are waiting in overcrowded rooms, which some days are “horrific.”
“You could argue Montefiore has been doing something to alleviate the lack of space,” she said. “But they need to do more.”
The department is also significantly understaffed, said Raymond, which led the nurses to file Protests of Assignments, which indicates when they are in situations that feel unsafe. They filed 128 protests this spring in a span of three months, she said.
NYSNA reviewed the situation, and recommend Montefiore hire 30 new nurses for the department, said Raymond, but they only agreed to 15 new hires.
“It was disappointing to us,” said Raymond. “We know what we need and we know what our patients need.”
Of those 15 new positions, nurses have been hired for nine of them, said White, and they are in various stages of the multi-step process to become staff.
The nurses are concerned about the situation worsening as flu season approaches, said Raymond, and will continue to push Montefiore to address staffing and space needs.
Although the local officials were encouraged by what they saw in July, Benedetto said they will continue to follow the issue and will address the needs of their constituents at a meeting with Montefiore officials on the subject next week.
Montefiore will continue to look for new ways to address the issue over the coming months, said Katz.
“It’s something we’re still working on,” she said.
