Ambulances, E.R.’s scramble to deal with St. Vincent’s loss
By Lincoln Anderson
Regarding the impact of St. Vincent’s Hospital’s closure, there’s no denying there has been an increase in the number of patients local hospitals are seeing in their emergency departments.
Jim Mandler, a spokesperson for Continuum Health Partners, said the change has been noticeable at Beth Israel Medical Center, on E. 16th St., which is part of the Continuum network.
“Oh, it’s been huge,” Mandler said. “From the first day that St. Vincent’s announced they were closing their emergency room, Beth Israel saw an immediate jump in daily visits to the E.R. by 20 percent and in ambulances by 40 percent — and those numbers have not decreased.”
However, Mandler said, there hasn’t been a similar spike at Roosevelt Hospital on W. 59th St., also part of Continuum, which, he noted, is “fairly close” to St. Vincent’s, but has seen only about a 5 percent increase in E.R. visits.
Beth Israel and Roosevelt hospitals were also authorized by the Fire Department to increase the number of their ambulance tours to help fill the gap left by St. Vincent’s, with Beth Israel running three more ambulance tours and Roosevelt two more.
Mandler said that when Cabrini Hospital’s E.R. closed two years ago, Beth Israel decided to expand its own E.R. capacity to accommodate the expected extra patients. When Beth Israel finishes its E.R. expansion and renovation this summer, its E.R. capacity will have more than doubled.
Although some news reports have said Downtown hospital E.R.’s are “filling up” and experiencing “crowding” after St. Vincent’s closure, Mandler downplayed those claims.
“Patient waits have not been incredibly long,” he said of Beth Israel’s E.R. “Walk-out rates [where patients leave the E.R. in frustration after a long wait without being treated] are 4 percent right now. We feel that the walk-out rate will definitely drop when we do the final [E.R.] renovation this summer.
“It’s not a crisis situation,” he said. “It’s very busy. We’re seeing a lot more patients than we were seeing.”
Beth Israel has also increased its number of active hospital beds by 30, he added. The hospital is licensed for 900 beds, but previously only had 600 active.
According to spokesperson Evelyn Hernandez, Bellevue Hospital also has experienced “a significant impact” from St. Vincent’s closing. Hernandez provided The Villager with Bellevue E.R. numbers for April and May 2008, 2009 and 2010. In spring 2009, city hospitals experienced a spike in patients due to the H1N1 flu, which “skewed the numbers” for that year, according to Hernandez.
This April, Bellevue’s E.R. average daily census (number of patients) increased more than 15 percent compared to two years ago, up from 270 patients in April 2008 to 311 patients in 2010. Boosted by the swine flu outbreak, in April 2009, there were 319 daily E.R. visits.
This May, Bellevue’s E.R. average daily census increased 19 percent, up from 290 patients in May 2008 compared to 345 in 2010. Again, in May 2009, fueled by swine flu, E.R. visits were up compared to the same period of 2008, with 323.
At the end of May, Downtown Express, The Villager’s sister newspaper, reported that New York Downtown Hospital, on Gold St. by the Brooklyn Bridge, had experienced a 30-to-35 percent increase in patients since St. Vincent’s closure, with daily E.R. patient visits up from 100 to around 130. However, after 9/11, the hospital beefed up its emergency capabilities, and is handling the extra patient load smoothly, according to hospital officials.
Also, the city has been working with hospitals to increase turnaround time for ambulances at local E.R.’s — getting patients into the E.R. faster and ambulances back onto the road more rapidly. According to Steve Ritea, a Fire Department spokesperson, the process has been cut down by 3 minutes at Beth Israel and Bellevue. Fire Department E.M.S. has covered all the ambulance tours that were done by St. Vincent’s, he added, along with the extra ambulance tours being added by Beth Israel and Roosevelt hospitals.
Ritea said E.M.S. response times for the borough of Manhattan have not increased since St. Vincent’s closed. The average response time in May 2008 and May 2009 was identical: 6 minutes and 45 seconds. In May 2010, response time dropped — to 6 minutes and 33 seconds. But, Ritea said, as a result of St. Vincent’s closure, after the ambulances respond to the scene, it’s taking an additional 3 minutes on average to get patients to an E.R. But this is where the quicker turnaround at E.R.’s is helping offset this increase, he noted, with the patients being whisked into treatment faster once they arrive.
According to former St. Vincent’s C.O.O. Arthur Webb, St. Vincent’s did its own analysis, which found that, on average, after pickup in the St. Vincent’s catchment area, it took ambulances 7 minutes to get patients to the St. Vincent’s E.R.; and that, without St. Vincent’s Hospital, delivery time would increase by 10 to 12 minutes.
Furthermore, Ritea said, the Fire Department is currently working to identify a spot in Greenwich Village or in the West 20s to open a new E.M.S. station by the end of this year, which would be the first E.M.S. station south of Harlem on the West Side. The E.M.T.’s and paramedics would go there to restock their ambulances with medical supplies, clean out the back of their ambulances and so forth. However, it wouldn’t be a walk-in clinic for patients, he said.