Los Angeles County/Us Medical Center Case Study

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Problem Statement: Will the addition of 150 hospital beds significantly decrease Emergency Department wait times at Los Angeles County/USC Medical Center? Scenario: Los Angeles County LAC+USC Medical Center (LAC/USC) was founded in 1878. In addition to being one of the largest acute care hospitals in the United States, it is also the nation’s largest academic institution and the primary facility of the USC School of Medicine. LAC/USC was originally established with 100 beds to serve 47 patients and grew to be licensed for 1,395 beds at its peak census period in 2006. Services provided by LAC/USC are comprehensive and include medical, surgical, emergency/trauma, obstetrics/gynecology, pediatrics, NICU and psychiatric care. Additional…show more content…
According to Rowena Payne who has worked as a full time Registered Nurse (RN) in the ED at LAC/USC for the past twenty five years, “There is no down time, we operate with six to eight triage nurses at all times and see about 300 patients every day”. She has seen first-hand the increased volume and patient acuity, poor staffing and challenges with inpatient bed availability. She cites the main culprits of extended ED wait time as “sheer volume” being the number one issue of concern followed closely by a lack of inpatient beds and the required “holding” of admitted patients in the ED for long periods. Payne confirms what research shows with regard to lack of primary care for the underserved population of Los Angeles by revealing that the majority of patients who are referred to clinics for follow up return to the ED instead. “I always ask them why they don’t follow up as instructed and the answer is always the same” says Payne, “They simply can’t get an appointment and when they show up at the clinic in person they are turned away”. Payne mimics the thoughts of Douglass regarding inadequate staffing and shorter clinic hours due to budget cuts and believes that these issues are a grim reality at all three clinics serving the Los Angeles area near LAC/USC. The Urgent Care Clinic operated within the LAC/USC ED itself is also unable to meet the needs of these patients even though it operates at full capacity. Payne confirms that, “Primary care is completely inaccessible for these underserved patients”. She is aware of a new “call back nurse” position being developed in the ED at LAC/USC to provide phone instructions for patients needing to return to the facility for tests and procedures. Currently at least ten patients per day (3%), come to the ED instead of going to their scheduled appointment elsewhere in the facility and the creation of this position should

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