WSAZ Investigates: E.R. Gridlock -- Has Anything Changed?

Published: May. 17, 2016 at 12:40 AM EDT
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UPDATE 7/18/16 @ 11:55 p.m.

KANAWHA COUNTY, W.Va. (WSAZ) -- For recent Kanawha County emergency room patient, Della Dean, a seat recovering from kidney surgery on her living room couch in Cross Lanes, is still less painful than her original seat; waiting for help.

"It was excruciating," Dean said. "[You] sit there all day...I prayed to die because I couldn't stand the pain."

Twelve hours over the course of two days, spent waiting just to get into ER's, was enough for Dean to become one of the many to reach out to WSAZ after our first report on ER wait times; which showed time from the parking lot to a bed averaged one full hour.

"It's just a bad situation," Dean said.

But in the two months since the initial report, medical professionals, like Lincoln County Emergency Services Director and Charleston Fire Department EMS Paramedic Allen Holder, say they've started to see a change for the better.

"There's no doubt your report made a difference," Holder said. "Occasionally we still have units getting stuck at a hospital for an hour, hour-and-a-half, that still's not happening quite as often as it used to."

The latest data we've obtained, from several ambulance services across the region, reflects this improvement.

Kanawha County Emergency Ambulance Authority records show the average wait time at Thomas Memorial Hospital, CAMC General Hospital and CAMC Memorial Hospital combined is now just 24 minutes.

But other data suggests the improvement is less substantial.

Charleston Fire Department EMS and Putnam County EMS have tracked an average wait time closer to 40 minutes.

Sample sizes could explain the gap between the amount of improvements. But, medical professionals say, new initiatives at all hospitals are helping across the board.

Thomas Health System officials in charge of ER reform, like Service Line Director Tim O'Neal, say since our story, they have partnered with a new physician staffing company to help recruit and retain ER staff members and to bring in consultants to help generate new ideas for a better patient experience.

"To help us identify what areas we can improve on," O'Neal said. "How to improve our processes, improve our throughput.

"A Band-Aid is not a fix for our community," O'Neal said. "We need a long-term solution for this problem."

Charleston Area Medical Center has implemented multiple temporary fixes that have drastically dropped wait times at their two busiest ER's.

One week after our original report, CAMC Memorial Hospital added a handful of extra beds to their ER unit.

Three weeks later, CAMC General Hospital added eight chairs for ER patients with less-serious conditions.

We reached out to CAMC, but they declined sitting down with us for an interview. But hospital spokesperson Dale Witte says these additions are getting ambulances back on the road faster for other patients.

In the first two weeks after the change at CAMC Memorial Hospital, KCEAA records showed wait times were averaging under eight minutes.

But, Holder says, in an area with decades of consistent ER issues, quick fixes have never stuck.

"We've seen the situation, over the years, improve for a few months and then get bad again," Holder said.

And a bad omen, as far as medical professionals are concerned, happened just last week; when the three biggest Kanawha County ER's were all backed up at the same time; overflowing with patients and paramedics waiting for beds to open up.

Holder says the future of ER wait times in Kanawha County is up in the air.

"I think it is uncertain," Holder said. "[Hospitals] have to hold themselves accountable on a monthly basis, look at their numbers, look at where they're at and make a very consistent effort to improve the problem."

As for Dean, optimism has been harder to come by from where she's sitting.

"I don't know if it'll ever really be resolved or not," Dean said.

For now; she and every other possible Kanawha County patient will have to wait to see if ER wait times go into remission or relapse instead.

UPDATE 5/23/16 @ 7 p.m.

KANAWHA COUNTY, W.Va. (WSAZ) -- Alarming wait times for Kanawha County emergency rooms, which average one hour from the time a patient's ambulance pulls into the parking lot until that patient gets a bed, have spurred one government official to take action.

After seeing WSAZ's investigation on E.R. gridlock and receiving numerous complaints from neighbors, Kanawha County Commission President Kent Carper says enough is enough.

"We will be meeting, at my direction, with the various managers of the hospitals," Carper said. "When you see a problem like this ... you ought to solve it."

Carper says he has no timeline for his planned meeting with officials from CAMC and Thomas Health System, but says he would like to discuss wait times as soon as possible.

"Sooner than later," Carper said. "The stakes are too high."

WSAZ Investigates found a community that took further action on long E.R. wait times.

Commissioners in Marion County, Florida, officially discussed a potential ordinance that would allow the county to fine hospitals for long waits.

We checked with them with to see if that worked. A spokesperson says the discussion alone prompted a variety of quick fixes that improved wait times. Now, commissioners are holding off on the ordinance while they monitor the situation.

Carper says Kanawha County has the ability to impose a fine, but would rather cooperate to find solutions as quickly as possible.

"We should be looking at protecting lives and limb," Carper said. "If you share the same goal, and you have the ability to understand things together, you should be able to work out any problem."

After our investigation aired, we heard from both hospital companies with long wait times.

CAMC spokesperson Dale Witte, told WSAZ that CAMC Memorial Hospital plans to add 48 beds and a waiting room for E.R. patients with non-life threatening injuries by July.

"It's a work in progress," Witte said.

Witte says no changes are in the works for E.R.s at CAMC General Hospital and CAMC Women and Children's Hospitals.

Thomas Health System President and CEO, Dan Lauffer, told WSAZ he wants to bulk up E.R. staff.

"We're doing the best we can," Lauffer said. "Each and every day."

Lauffer says replacing the old E.R. at St. Francis Hospital with St. Francis First Health and Wellness Center will help spread out patients who need urgent care, but not necessarily emergency care.

Carper disagrees, saying fewer E.R.'s will directly translate to more strain on the emergency system.

"That will not improve wait time, having one less emergency department," Carper said. "That's nonsensical."

Kanawha County Emergency Ambulance Authority data shows, in April, there were 138 E.R. waits more than an hour long at their three most transported E.R.'s; CAMC General Hospital, CAMC Memorial Hospital and Thomas Memorial Hospital.

The data also shows that while KCEAA ambulances transported to CAMC General Hospital more frequently than any other hospital, crews faced hour-long waits three times more often at Thomas Memorial Hospital.

ORIGINAL STORY 5/16/16 @ 7 p.m.

KANAWHA COUNTY, W.Va. (WSAZ) -- In her time of need, Cayte Vigilante was numb on her left side and scared at a Charleston emergency room last spring.

"I was afraid I was going to have a stroke," Vigilante said. "I felt completely helpless."

And help was not coming anytime soon.

"I was there over six hours waiting," Vigilante said.

But the longest wait of Cayte's life is just part of what EMT's say is an ongoing problem in Kanawha County; long wait times for all emergency room patients.

As the director of Lincoln County Emergency Services and a paramedic in the city of Charleston, Allen Holder says long E.R. wait times happen every day.

"[Patients are] in pain longer than they should be and in some cases have probably died from the lack of EMS care because of the hospital wait time." Holder said. "We have a serious problem in the Charleston-Kanawha County area."

WSAZ gathered Kanawha County Emergency Ambulance Authority data from 2015, showing the average emergency room wait time in the county is one full hour, from the time an ambulance pulls into the emergency bay to the time that patient gets a bed and EMT's return to service.

Data shows some patients transported by ambulance are waiting as long as four hours in the four Kanawha County E.R.'s: CAMC General Hospital, CAMC Memorial Hospital, CAMC Women and Children's Hospital and Thomas Memorial Hospital. CAMC Teays Valley Hospital and Montgomery General Hospital are included in KCEAA data.

WSAZ checked on other hospitals in our region to get their wait times too.

At Logan Regional Medical Center, emergency workers say the wait is usually 15 to 30 minutes.

EMS professionals in Ohio say they rarely wait, at all, for beds at any of the Holzer hospitals or at Southern Ohio Medical Center; although paperwork can delay the return to service for the EMT's by about 20 to 30 minutes.

EMT's in Kentucky say no wait times are also the norm at King's Daughter's Medical Center and Our Lady of Bellefonte Hospital; again, paperwork bumps wait totals to 20 to 30 minutes.

And, just 50 miles away from Charleston, EMS professionals in Cabell County say you'll wait an average of less than ten minutes to get a room at Cabell-Huntington Hospital and St. Mary's Medical Center.

Ambulance and crew are required to stay with the patient until they are in a bed, meaning the longer the wait, the longer first responders are kept from helping other patients in need.

"Worst-case scenario, your mother, father, you get sick and there aren't ambulances to send to you because they're sitting at the hospital waiting for a bed," Holder said.

That ripple effect spreads far beyond Kanawha County.

In Lincoln County there are no emergency rooms.

Lincoln EMS Director Trish Watson moves patients to hospitals in surrounding counties instead.

She says going to Huntington and Logan is quick and painless, but sending patients to Charleston puts a strain on their three ambulances.

"I've sat with patients who wait so long to ask if they could go to another place," Watson said.

And, she says, re-routing happens with patient permission.

"Have I ever, as a medic, said, 'Trucks sent there are waiting a couple hours, are you sure you wouldn't rather go to Huntington?'" And have patients agree to do that? Watson said. "Yes I have."

In Huntington, Cabell County EMS Director Gordon Merry III says open channels of communication with the hospitals in town keeps everything moving smoothly.

"When you walk in the door, they're handing us a bed assignment," Merry said. "They have a sheet, they lay it on the counter and when we come in we know what bed we're going to the minute we come through the door.

"They're waiting for us," Merry said.

Watson says that urgency makes all the difference.

"Huntington is a little quicker, if [the patient's condition is] not life-threatening, moving them," Watson said. "Charleston often doesn't do that."

"They often just leave them sitting with the ambulance crew," Watson said.

KCEAA spokesperson, Mike Jarrett, says longer wait times are partially caused by a lack of resources.

"I think staffing in the E.R.'s sometimes is a challenge," Jarrett said.

WSAZ asked officials with CAMC and Thomas Health Systems for an interview, but both hospitals released statements.

A spokesperson with Thomas Health Systems says Thomas Memorial Hospital staff are aware of their wait times and are committed to improving their processes.

CAMC's spokesperson says they too would like to improve their flow of patients, and that plans for expansion are in the works at CAMC Memorial Hospital.

After waiting for six hours at CAMC Memorial Hospital's E.R. last spring, help for Cayte Vigilante did come eventually.

She was alright, but says the fear of waiting so long is something no one else should experience.

"People need to understand this is unacceptable," Vigilante said.

Now, she is hoping her neighbors won't be forced to wait for a solution before times runs out on someone else.

"This needs to be quicker," Vigilante said. "Something needs to be revamped and changed so there's not such a wait."

EMS workers say, no matter the hospital, the E.R.'s do try to prioritize who gets a bed, based on the severity of the emergency.

But, medical professionals say wait times can get so backed up in Kanawha County, it's common for EMT's to test and treat patients in the ambulance from the parking lot.

Charleston just lost an E.R. at St. Francis Hospital, converting into an urgent care facility; St. Francis First.

At this point, medical professionals say it's still too early to tell whether that will have any impact on wait times in Kanawha County.