Why is the ED so crowded and what we're doing about it
The Doc Smitty addresses the wait times and solutions of Cook Children's busy ED
My wife nudges me. It’s 2 a.m.
“Hey babe, did you hear that? Who is coughing? Can you go check on them? Take your stethoscope.”
That’s what an Emergency Room visit looks like in our house in the middle of the night. This time of year, many of you might wish you were married to a pediatrician … but, alas, Mrs. Doc Smitty is one of the few with that privilege.
We at Cook Children’s, and hospitals around the nation, have seen a significant rise in the use of our Emergency Departments and Urgent Care Centers over the past few weeks. Not only are we seeing more kids, many of those kids are more complex and more sick than we have seen in previous years. We are seeing RSV, flu, vomiting/diarrhea and just about every other pediatric illness you can imagine. It’s all going around.
Not only do we find ourselves servicing our local area, we are accepting transfers from most of North Texas in an effort to provide service to very ill patients who need the level of care that Cook Children’s can provide. This responsibility is based on Cook Children’s promise that every child’s life is sacred.
But that important commitment to helping so many children means helping a lot of kids. Here’s what we know that means to you.
We know that wait times are longer than usual right now.
We follow the trends in wait time closely – both at our medical center and in our region. All across Dallas-Fort Worth, hospitals are experiencing this surge in visits and we are hearing about increased wait times at emergency rooms throughout the area.
We are working to address this issue. We are increasing the number of providers ready to work in the ED. These are not our regular ED physicians but physicians who will be available to help out with patient surges after their “day jobs.” We are working to educate our families about other locations where they can receive care. Unfortunately, once a patient is checked in at the ED, we cannot ask that they leave to receive care elsewhere. Asking them to leave would be a violation of a law known as EMTALA.
Another issue we are facing is limited space. Hospital beds are filled with sick children that are not ready for discharge. This requires that children who need admission remain in our ED as they wait for a room in the hospital.
Space in the ED is already limited based on the fact that it was built to accommodate 45,000 visits per year but is currently seeing more than 120,000. Much of this problem will be addressed when our new Emergency Department opens, but, for now, we have to work to maximize the use of the space that we have.
Therefore, increasing providers will not cut your wait time down to zero but we will do our best to shorten it as much as possible.
You can help by utilizing our various other ways to care for your child’s medical issues addressed. Do not hear this as a lecture to not go to the ER; that is not the point of this post. We are working hard to provide other means that might help you by addressing the problem more quickly. Consider calling your Cook Children’s pediatrician. Even if they are not open, you can get advice from our outstanding pediatric nurses who can take your phone calls overnight. If your issue requires a visit but the ER seems like too much, check out one of the four Cook Children’s Urgent Care Centers throughout the Fort Worth area.
We know that waiting is terrible.
Doctors are some of the most impatient people I know. I don’t like to wait for anything. I get antsy and frustrated and become very difficult to deal with. If the radiology report or the lab result takes longer than expected, our anxiety level goes up. When we know our patients are suffering and we need those results to relieve suffering, we become even more frustrated. We hope you don’t sense our frustrations as frustrations with you. We just hate to see kids sick and to see more of them sick than usual makes us all sad.
You can hear the frustration in this brief interview with Corwin Wormink, M.D., Cook Children's Assistant Medical Director of Emergency Services.
We are working to address this issue. We are working to speed up all the processes associated with caring for your children so that our providers can be as efficient as possible. We are working to support providers (doctors, nurses and all other staff) so that they can be energized (physically and emotionally) to continue to provide excellent care for your child.
We know that waiting with a sick child is even worse.
We hate it that you are waiting hours to be seen in our ER. When our providers walk into the room and see that you’ve been waiting, our heart hurts about the time you’ve spent sitting in an uncomfortable chair trying to corral your sick child (often with their siblings). We know that you are worried about your child because he or she is sick. You’ve been scared to go to the bathroom, afraid you might miss your name being called out and that you are hungry and tired.
We are working to address this issue. We are looking to staff volunteers in the waiting rooms to help you get to where you need to be, to provide distractions for your children and to do anything they can to help you while you wait. We also are looking to increase our use of text and other notifications to update you on the status of your wait times, need for vital sign checks and other issues. Even when you are waiting, unable to be seen by a doctor, our triage nurses are checking and re-checking your child’s vital signs to make sure that your child’s medical condition is not changing, requiring them to be moved up in line to be seen sooner.
Your child is important to us.
Despite the fact that the numbers of children in the ED are high, we want to continue to provide the best care for your child. No matter how long your wait, we want you to feel like your concerns and questions have been addressed and that you have received the personal care your child deserves. If at any point, you do not feel like you have received that level of care, feel free to reach out to us at 682-885-6698.
You may not have a pediatrician lying next to you in bed for a quick ER check in the middle of the night but we do want you to know that we are here for your child in many other ways. Start by picking up the phone and calling your pediatrician or nurse triage line. If you decide your child needs to be seen, think about trying one of our Urgent Care Centers or in an emergency, our Emergency Department.
Our providers in each area are ready to provide the best care for your child.
Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.