Hospitals struggle to maintain standby services

Hospitals lack the support and explicit funding needed to fulfill their standby role--providing 24/7 healthcare care access, safety-net care and disaster response services, reported AHA News Now.

For example, hospitals must keep extensive resources and workers available to meet the various and unpredictable needs of emergency care patients, according to a report released yesterday by the American Hospital Association.  

In fact, a large urban hospital ED must be prepared to treat more than 1,600 unique patient conditions, the report noted.

Even though more than half of ED visits occur outside of normal business hours, hospitals don't receive funds for making sure their staff and facility is always prepared. Payment comes only when a patient arrives with an emergency condition, the report noted.

"Emergency care is about being prepared for the unexpected all the time. We have to have all our resources ready to care for the highest levels of demand every hour of every day," Coreen Vlodarchyk, chief nursing executive and vice president for patient care services at Barnes-Jewish Hospital in St. Louis, said in the report.

The standby role also faces pressure from increased expectations for disaster preparedness. Communities rely on hospitals to care for the sick and injured, as well offer a safe haven during a disaster.

Therefore, hospitals invest significant time and money to developing and testing disaster response plans, training staff, and maintaining equipment and supplies. Yet, explicit funding for disaster preparedness has been shrinking of late, coupled with reimbursement for disaster relief often falling short of expenses.

The challenges to ensure future hospital standby capacity could have implications for policymakers as they consider a "site-neutral" Medicare policy that would pay hospitals and physician offices the same amount for certain outpatient services, essentially reducing hospital payments by billions.

For more:
- here's the report (.pdf)
- read the AHA News Now brief