November 10, 2009

Discharge lounge latest in changes to aid ER wait time

The University of Chicago Medical Center (UCMC) will open a pilot discharge lounge for recently discharged patients Wednesday, the most recent in a series of changes that came out of a review of the hospital’s emergency room policies.

After facing accusations of patient-dumping and sub-par care last year, the UCMC hired advocates to conduct the review. They consulted with released emergency room (ER) patients, created staff positions to transfer lower risk patients to other hospitals, and streamlined its admissions and ER waiting room policies.

Wait times have decreased 65 percent since the changes, according to UCMC officials.

The discharge lounge is intended for patients waiting to be picked up after receiving care in the ER and will operate Monday through Friday between 10 a.m. and 8 p.m. The lounge will allow patients to wait more comfortably to go home, and create more space in the ER, UCMC officials said. Until now, discharged patients have often waited in their beds, taking up valuable ER space.

“We’re hoping that by freeing up inpatient beds and allowing patients to wait in comfort in the discharge lounge, [we will] see an improvement in both our ER and our recovery room areas,” said Jean Blake, a hospital operations employee who helped set up the discharge lounge.

The lounge follows other steps taken to combat criticism of the hospital for the implementation of the Urban Health Initiative (UHI) last year. The UHI was designed to help patients using the hospital for primary care to transition to clinics on the South Side for regular, non-emergent care.

Many critics claimed that it resulted in uninsured and low-income patients being turned away from the emergency room.

Dr. Everett Vokes, acting UCMC chair, subsequently conducted a review of Emergency Department policy that resulted in the changes that took place over the spring and summer. These also included changing the ER admissions policy to make it more efficient and creating a surge plan to deal with overcrowding in the ER.

The discharge lounge will be available to three to four patients at a time, though Blake said the hospital hopes to accommodate more patients in the future.

Blake said there will be boxed lunches, water, and a handicapped accessible bathroom. “We will have it staffed with a nurse aide who will assist with making phone calls or will get a patient a blanket and will actually wheel a patient out to the curb so their family can pick them up,” she said.

Blake said the hospital would help more patients learn about the discharge lounge. “We’re going to probably do education for the different services in the hospital making sure that the physicians know that this is available for patients. The way it will be successful is if the care team can talk about it,” she said.

She added that measures of success would be how many people use the lounge and whether the ER beds will be efficiently reassigned after they become available, as patients are transferred to the lounge.

“This is one of many, many steps that we’ve taken to try to take the pressure off the emergency room,” said John Easton, a spokesman for the UCMC. “There are a whole lot of things that have been put in place since the spring. This is a small change, but this is the most recent one and something that should make a difference.”