ER backups prompt new calls to open D.C. General

(Published August 11, 2003)

By KATHRYN SINZINGER

Staff Writer

Overcrowding at D.C. emergency rooms, particularly since the downgrading of D.C. General Hospital to an urgent care center in May, has become so severe that ambulances have sometimes been unable to discharge their patients because ER beds were filled, according to hospital officials and local health care advocates.

The recent upsurge in overcrowding, coupled with the cityís threat to close bankrupt Greater Southeast Community Hospital if it cannot resolve quality of care problems within 60 days, has prompted a coalition of ministers and health care activists to call for the immediate reopening of D.C. Generalís emergency room. The coalition, led by the Rev. Willie Wilson of Union Temple Baptist Church, also announced Aug. 7 that it will seek a citywide vote on building a new public hospital.

Emergency room overcrowding has become especially severe at Providence Hospital, Childrenís National Medical Center, George Washington University Hospital and Sibley Memorial Hospital. The D.C. Hospital Association says the number of ER visits at each of those hospitals has increased from 22 percent to 28 percent.

Health care advocates, who have recently resumed monitoring emergency room activities, cited as an example a backup of eight ambulances waiting to discharge patients at Providence Hospital. Sister Carol Keehan, who heads the hospital staff, was on vacation and unavailable for comment last week but has repeatedly expressed concern about the inadequacy of the Districtís emergency medical services since D.C. Generalís closure.

"Everybody seeking care is having to wait, regardless of their insurance status," said Joan Lewis, vice president of the D.C. Hospital Association.

Lewis said the hospital association board met in June with Dr. Fernando Daniels, head of ambulance services for the D.C. Fire and Emergency Medical Services Department, who expressed concern about the inability of some arriving ambulances to immediately transfer their patients to emergency room care.

Daniels was on vacation and unavailable for comment last week. His assistant also was unavailable. City Administrator John Koskinen, who has taken the lead in publicly commenting for the Williams administration on the Districtís current health care crisis, also was on vacation and unavailable for comment. A spokeswoman for Mayor Anthony A. Williams deferred to a spokeswoman for the D.C. Department of Health, who said she was unable to provide comment before this issue of The Common Denominator went to press.

The fire department, long criticized for slow rescue response times, also is battling internal dissension over a new ambulance staffing plan that union officials say will jeopardize quality of care for ambulance patients. The plan, scheduled to go into effect Aug. 12, allows ambulances to be staffed with lesser-qualified emergency medical personnel in an effort to compensate for the departmentís continuing inability to fill its vacant paramedic positions.

"Our mayor needs to be honest, humble and honorable by first admitting that he has made a grave error and then do the right thing by reopening D.C. General as a full-service public hospital," Rev. Wilson said Aug. 7 during a press conference at which he and other representatives of the D.C. Health Care Coalition announced a series of planned actions designed to gain support for the restoration of a public hospital in the District.

Wilson, speaking to news media in front of Greater Southeast Community Hospital, cited the deaths of two of his church members in Greater Southeastís emergency room that he said "quite possibly could have been avoided" with more prompt medical attention and called on city health officials to follow through on their threats to close Greater Southeast.

"We already donít have a hospital here ... in terms of the services being rendered," Wilson said. "We cannot compromise the value of human life, and thatís what weíre talking about here."

Wilson said a series of "peopleís hearings," with the first scheduled Aug. 11 at Union Temple Baptist Church, are planned during the next two months at which members of the public and health care providers will be encouraged to share their experiences of "undue suffering because of inadequate treatment or service in the emergency rooms of all of the Districtís hospitals." The coalition plans to forward information gathered at the forums to the city council and the mayor.

A second "peopleís hearing" is scheduled for 11 a.m. Aug. 30 at St. Lucille AME Zion Church, 5100 Astor Place SE. Other forums are being planned in September at churches across the city, according to the coalitionís Devin Walker.

Walker said the coalitionís efforts are gaining momentum within the faith-based community and already have the support of Bishop Milton A. Williams, who presides over 80 regional AME Zion churches, the Rev. Mildred King of Greater Good Samaritan Baptist Church, the Rev. Graylan Hagler of Plymouth Congregational Church, Bishop Imogene Stewart of Greater Pearly Gates Baptist Church and other local ministers.

Among the coalitionís plans is a citywide march from the D.C. General campus to the U.S. Capitol in October "to raise the level of this issue beyond D.C. General to show that the state of emergency health care in the nationís capital is a national security risk," Walker said.

D.C. General was closed as a full-service hospital in mid-2001 after a lengthy, acrimonious debate that pitted public sentiment, most of the local health care community and a unanimous D.C. City Council against the mayor and the then-ruling financial control board. The control board voted to replace the public hospitalís services for the indigent and uninsured with an alliance of private health care providers, with financially troubled Greater Southeast Community Hospital as its prime contractor.

Management of the health care alliance was taken over by the D.C. Department of Health earlier this year, following Greater Southeastís filing for Chapter 11 bankruptcy protection last November. Greater Southeast recently was denied recertification by the Joint Commission on Accreditation of Healthcare Organizations due to deficiencies in its patient care operations, a decision that jeopardizes the hospitalís ability to bill for Medicare and Medicaid services. The hospital has appealed the decision.

Copyright 2003, The Common Denominator