The state of emergency medicine in Pennsylvania is improving, but a national report card from the American College of Emergency Physicians, or ACEP, shows the commonwealth lagging behind the rest of the US in some categories.
Overall, the state received a grade of "C+," which was compiled by looking at several areas.
“The five categories of each metric were access to emergency medicine and emergency care, quality and patient safety, medical liability environment, public health and injury prevention and disaster preparedness,” said Dr. Scott Fijewski, ACEP spokesman and emergency physician at St. Clair Hospital.
Most notably, Pennsylvania’s grade in access to emergency care shot up from a "C-" in 2009 to a "B+" in 2014. That moved Pennsylvania from 23rd in the nation up to 2nd when it comes to access. Still, the grade is a mixed bag.
“In our state we have an increased number of ED (emergency department) visits, but we have a decreased number of emergency departments, a decreased number of staffed in-patient beds and a decreased number of psych beds,” said Fijewski. “So our hospitals in general do run a higher-than-average occupancy rate.”
This could become an issue in the event of a large-scale disaster or emergency. Fijewski likens it to a restaurant.
“Imagine a restaurant that nobody ever leaves,” he said. “If nobody ever left, then no new customers, or new patients in our case, can come through the front door. Because our hospitals run at a high occupancy rate, we have a problem with overall bed shortages.”
The report card states one suggestion for a fix is to adopt a statewide psychiatric bed registry.
The state’s highest grade was an “A” for quality and patient safety environment. The high mark is attributed to statewide systems and policies in place for heart attack, stroke and trauma patients. Pennsylvania also supports the fourth highest rate of emergency medicine residents in the country.
The lowest grade was an “F” in the category of medical liability environment. That fell from a "D-" in 2009. While Fijewski said there have been small improvements, such as expert witness qualifications, it’s not enough.
“These are not keeping pace with improvements seen in other states. That is why our grade has dropped,” he said. “Without meaningful medical liability reform, our state can lose several qualified doctors and other medical professionals to states that have better protections against frivolous lawsuits.”
Fijewski said emergency departments are safety nets for many people and even though more people will have health care coverage under the affordable care act, ED visits are expected to continue to increase. The goal of the report card is to draw attention to areas that need to be addressed.
“Overall, nationally, the grades should be alarming,” Fijewski said. “The overall average grade in America was a ‘D+.’ This is a chance for Congress and President Obama to make it a national priority to strengthen legislation for emergency departments going forward."
The full report card can be found online.