Variety of factors lead to 'chronic' ED overcrowding at VA, report finds

The Memphis VA Medical Center's emergency department length of stay is "far below the VHA standard," and suffers from "chronic" overcrowding, according to a report released by the VA's Office of Inspector General.  

The OIG found that  27% of patients had ED lengths of stay of more than six hours; some were in the ED as long as 14 hours waiting for admission or a transfer. The most significant factor affecting wait times was the lack of medical/surgical beds.

Other problems discovered during the OIG's investigation included the fact that there is no mechanism to admit mental health patients from 10:00 p.m. to 5:00 a.m., causing patients to be transferred by ambulance to the community hospital during those hours and then transferred back to the VA the next day; inappropriate ED visits by patients; lack of 24-hour ultrasound services; unreliable ED data; and inadequate action by management to resolve these issues.

The OIG did not find that these problems had adversely affected patient safety.

The OIG recommended that the facility director reduce ED length of stay, provide ultrasound services at all times and ensure the accuracy of ED data. The VA concurred with the recommendations and noted that the facility had already opened six new medical/surgical beds and nine mental health beds. The facility has also added staff to perform ultrasounds.  

The Memphis VA is not the only hospital suffering from ED overcrowding, although the reasons for it vary. At least one hospital has blamed its EHRs for increasing ED length of stay.  

To learn more:
- here's the OIG report
 

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