Pa. emergency care can improve with sound policy

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In the 2014 American College of Emergency Physicians report card, Pennsylvania ranked sixth in the nation receiving a grade of C+ for its support of emergency care, identical to the 2009 grade.

Pennsylvania made dramatic improvements in access to emergency care, moving from 23rd to second, scoring a B+. However, we still have concerns. An aging workforce and poor medical liability environment could exacerbate physician shortages in the future. Boarding and crowding continues to be a major problem in our emergency departments and is defined by when admitted patients remain in the emergency department for longer than two hours because admission beds are full and not available. Additionally, finding placement for patients who require inpatient psychiatric care is difficult and time-consuming. The state should adopt a statewide psychiatric bed registry to decrease the boarding of these patients.

Pennsylvania’s medical liability reform grade decreased from a D- to an F. Without meaningful reform Pennsylvania runs the risk of losing additional physicians. House Bill 804 will be a first step in achieving meaningful reform. This bill changes the standard of evidence in liability claims from a “preponderance of evidence” to “clear and convincing evidence” in cases involving emergency care.

Pennsylvania’s quality and patient safety grade remained an A, citing statewide policies/​systems for the care of stroke, heart attack and trauma patients. In addition, to maintain excellent quality and patient safety, the state should develop an operational prescription drug-monitoring program to decrease narcotic addiction and abuse.

Disaster preparedness decreased from an A to a C+ due to decreased funding and decreased bed surge capacity. Public health and injury prevention decreased from a B- to a C- due to high infant mortality rates, unintentional poisoning related deaths, the lack of a helmet law and failure to pass smoking bans in bars.

Emergency medicine is the safety net that our health care system is built upon. We are available 24 hours a day, seven days a week, 365 days a year to care for the sick and injured. We need sensible policies to help us continue this mission and improve care for our patients. Additional information may be found at www.emreportcard.org/.

TODD FIJEWSKI, M.D.
Coraopolis

The writer is treasurer, Pennsylvania American College of Emergency Physicians.


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